[villagerjack]

Originally Posted by JoMar

I have United Healthcare PPO in the Villages Health System.....my copay is 50.00 for specialists. Not sure where the 300.00 comes from.

Have you had any X-rays or radiation? The charge is 20% under the Villages Health Plan.

[villagerjack]

Originally Posted by JoMar

A curiosity question, if you get a second opinion that is different from the original opinion what do you do? I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Going to a peer only puts you in the position to make a decision which begs the question, how do you do that if they disagree? In TV and dermatology who would you go to? And, if you think the doc that is giving you the second opinion is better than the original doc why aren't you going there initially? Just curious?

During 2014/2015, I visited three separate Dermatologists. One up North and two in The Villages as I had to change doctors due to an insurance change. I let each doctor make his/her own decisions. This went on for close to a year. Each doctor took their own biopsies on entirely different areas, some more than others but during the course of the year, each doctor concentrated on different areas and ignored other areas that the other doctors thought were important. On at least one occasion, when a doctor wanted to biopsy, I told him I did not have the time and to spray it instead with LN. It was gone by the time I visited the next doctor.

On another occasion, I had a biopsy taken and was informed it was Squamous. Since I was headed up North for the summer, I could not have the surgery in The Villages. During the summer, I received a letter from the doctor telling me that if I did not have the surgery, it could spread and result in death. I showed this area to my Northern Dermatologist and he looked at it carefully, sprayed it with LN and it went away completely in two weeks.

I have been going to a Dermatologist religiously 4 times a year for at least the last 20 years and only in the last 5-6 years have I noticed a large increase in requests for surgery. In the first 15 years I had one surgery. I have had many since then but this last year visiting 3 separate doctors made me very cautious.,I am sorry to say that for the first time in 20 years, I am now beginning to question the need for some of the surgeries from Dermatologists not just in The Villages but some here apparently do their "fair share" even the "good" ones getting great recommendations.

I don't know what the solution is for you. Perhaps to go to another doctor as a new patient and get a body exam and see if he comes up with the same diagnosis and areas as the other doctor did. Personally, I am very skeptical of all the dermatologists. There is way too much surgery done.MY OPINION ONLY.

[2BNTV]

Originally Posted by villagerjack

Have you had any X-rays or radiation? The charge is 20% under the Villages Health Plan.

Or possibly, outpatient surgery charge?

[AJ32162]

In my opinion dermatology is more art than science, particularly when it comes to visually determining whether or not a skin lesion is cancerous or benign. I have had four skin cancers to date, three of which looked benign on visual inspection by three different dermatologist. The only accurate way to determine if a lesion is cancerous or not is through a biopsy. If performed correctly a biopsy will leave only a minimal scar, barely noticeable. Personally, I would rather have ten too many biopsies than one too few.

I did have a lesion frozen above my right eye about five years ago and it healed completely, or so I thought. Recently, I developed a lesion in the same spot which I had biopsied. The result was a deep basal cell carcinoma which Dr. Casper said had probably been growing for several years. He removed it with MOHS and said the surgery would have been less invasive, had it been detected earlier (five years ago?) through a biopsy instead of being frozen with LN.

So, if a dermatologist has any doubt as to the malignancy of a suspicious lesion, I request a biopsy. The downside is that several biopsies have proven to be unnecessary...and I can live with that as they have left no noticeable scars. Anyone who has delayed treatment for skin cancer can attest to just how destructive and disfiguring it can be. Caught and treated early it is your best chance for a cure and better cosmetic results. Well, that's just one man's opinion, make of it what you will.

[JoMar]

Originally Posted by villagerjack

During 2014/2015, I visited three separate Dermatologists. One up North and two in The Villages as I had to change doctors due to an insurance change. I let each doctor make his/her own decisions. This went on for close to a year. Each doctor took their own biopsies on entirely different areas, some more than others but during the course of the year, each doctor concentrated on different areas and ignored other areas that the other doctors thought were important. On at least one occasion, when a doctor wanted to biopsy, I told him I did not have the time and to spray it instead with LN. It was gone by the time I visited the next doctor.

On another occasion, I had a biopsy taken and was informed it was Squamous. Since I was headed up North for the summer, I could not have the surgery in The Villages. During the summer, I received a letter from the doctor telling me that if I did not have the surgery, it could spread and result in death. I showed this area to my Northern Dermatologist and he looked at it carefully, sprayed it with LN and it went away completely in two weeks.

I have been going to a Dermatologist religiously 4 times a year for at least the last 20 years and only in the last 5-6 years have I noticed a large increase in requests for surgery. In the first 15 years I had one surgery. I have had many since then but this last year visiting 3 separate doctors made me very cautious.,I am sorry to say that for the first time in 20 years, I am now beginning to question the need for some of the surgeries from Dermatologists not just in The Villages but some here apparently do their "fair share" even the "good" ones getting great recommendations.

I don't know what the solution is for you. Perhaps to go to another doctor as a new patient and get a body exam and see if he comes up with the same diagnosis and areas as the other doctor did. Personally, I am very skeptical of all the dermatologists. There is way too much surgery done.MY OPINION ONLY.

I go to the dermatologist 4 times a year, for the last 15 years. Dr. Casper was consistent with what my northern guy did, and found. I do a full body exam yearly (probably because that's all the doc can handle ). My question was, and I believe was answered, is that peer second opinions are a search to find a doctor that gives the patient the diagnosis they want. For whatever reason, you had more faith or trust in your northern guy or had little or no trust in your guy down here. Either way, your concern was that there were too many surgeries performed. Your northern guy's diagnosis justified that so you went with him. As a previous poster stated, I think that happens more that we think. I might have asked the two docs to discuss what they found for a meeting of the minds. Both my wife and I have taken advantage of second opinions but they have always been up the chain, not peer to peer.

[tedquick]

Originally Posted by JoMar

A curiosity question, if you get a second opinion that is different from the original opinion what do you do? I always believed that if you go for a second opinion it would be to doctor or hospital that has significantly more accreditation, experience or a National recognition as an expert in the field. Going to a peer only puts you in the position to make a decision which begs the question, how do you do that if they disagree? In TV and dermatology who would you go to? And, if you think the doc that is giving you the second opinion is better than the original doc why aren't you going there initially? Just curious?

JoMar, that is an excellent question. After thinking about it more, as long as I'm seeing Dr. Casper I will not go for another opinion. I keep reflecting back to the time that he kept looking at a spot and finally said "I think we should biopsy this spot right here". He did but it turned out that it was benign. I was, and as I reflect on that, impressed with what I will call a very careful approach. I do not think that he freezes more than is necessary nor do I think he biopsies more than he should. I simply trust him.

[villagerjack]

Originally Posted by 2BNTV

Or possibly, outpatient surgery charge?

20% Co Pay for Radiation.

[JoMar]

Originally Posted by tedquick

JoMar, that is an excellent question. After thinking about it more, as long as I'm seeing Dr. Casper I will not go for another opinion. I keep reflecting back to the time that he kept looking at a spot and finally said "I think we should biopsy this spot right here". He did but it turned out that it was benign. I was, and as I reflect on that, impressed with what I will call a very careful approach. I do not think that he freezes more than is necessary nor do I think he biopsies more than he should. I simply trust him.

So do I.

[phillygirl]

Has anyone used dr Casper for MOHs on their face then dr Ahumada a plastic surgeon for the stitches/closing up? Thank yiu

[fl boomer]

I'm a 6 year melanoma survivor, and I once asked my Dermatologist about using LN on spots, and whether that would keep them from turning into future skin cancers. She cautioned me and said that a doctor has to be careful what spots they freeze because there can be underlying skin cancer which might go undetected and continue to spread.