I wrote the previous article with the expectation that readers familiar with the realities of dermatology would understand its somewhat tongue-in-cheek tone, including a degree of self-mockery directed at older dermatologists. However, I have since become concerned that, if taken literally, it might give the impression that only a handful of dermatology specialists will be needed in the future and that the rest of dermatologic care could simply be entrusted to general practitioners.
In fact, I believe the opposite. I think that dermatology specialists—especially those working in university hospitals, teaching institutions, and major medical centers—will become even more important in the years ahead.
With that in mind, I would like to add some further thoughts and revise certain points, hence this follow-up article, The Future of Dermatology – A Further Reflection.
Of course, cutting-edge treatments will increasingly rely on expensive therapies such as biologic agents. However, when viewed in the context of dermatologic diseases as a whole, the number of patients who truly require such treatments remains relatively small. Even in melanoma, the key remains early diagnosis. If detected at a very early stage while confined to the epidermis, surgical treatment alone can achieve an almost complete cure. Likewise, most cases of urticaria and atopic dermatitis can still be effectively controlled using conventional treatment methods.
Ultimately, what remains essential is accurate diagnostic ability and sound therapeutic skill. Dermatology encompasses an enormous number of diseases—well over a thousand by some estimates—and many are so rare that a dermatologist may never encounter them during an entire career. To deal with such a wide variety of conditions efficiently and accurately requires many years of training and experience.
In my previous article, I used the analogy of a seasoned warrior being outmatched by a young recruit. That comparison applied only to certain newly emerging technologies and treatment modalities. In most respects, however, it is obvious that a novice physician cannot match the expertise and judgment of a veteran who has undergone years of rigorous training.
Certainly, advances such as artificial intelligence, genetic medicine, telemedicine, and remote diagnosis will increasingly become part of everyday medical practice. That is the direction in which medicine is moving. Nevertheless, I am convinced that the fundamental role of the dermatologist will not change all that dramatically.
Perhaps some of what I have written here differs from the message of my previous blog post. In truth, none of us can know exactly what the future will bring. Yet the views expressed here more accurately reflect my own thinking.
That said, the paradigm shift I mentioned previously is undoubtedly underway, and medicine faces a growing number of challenges. If we simply drift along without paying attention, we will inevitably be left behind by the changing times.
Many distinguished physicians have already pointed this out and continue to sound the alarm.
English version prepared with AI assistance
(Originally published in Japanese)
Japanese version: