Letter to the Chairman of Johns Hopkins Department of Dermatology and His Reply

Below is my letter to the Chairman of the Johns Hopkins Department of Dermatology, which his assistant delivered to him on Oct 16, 2013.  The actual names of the Docs involved are of course in the letter to the Chairman.  I decided to refer to them as X and Y for my public post to protect the innocent and the guilty :). Below my letter is his reply.
-----------------------------------------------------

October 15, 2013

Mr. Sewon Kang, MD

Chairman

Johns Hopkins Department of Dermatology
Cancer Research Building II – Suites 209 & 210
1550 Orleans Street
Baltimore, MD  21231

Dear Doctor Kang:

I am writing to tell you of an incident which I believe represents a serious shortcoming in your department's treatment of a patient. One in which the department missed a significant opportunity to provide good patient care and more importantly, to learn from the experience to provide better care to other patients.

3 months ago, a 76 year old man, in excellent health, I experienced the onset of a rare disease, Pityriasis Rubra Pilaris and began treatment with my long-time dermatologist Dr. X of ________. As my condition worsened and with Dr. X's support, I sought answers with your Department of Dermatology. I was pleased with the doctor assigned to my case, Dr. Y as well as my experience with her in a number of appointments, until my last visit on October 8, 2013.

Prior to this last appointment, I had told her that I was going to pursue a “natural” course of treatment including diet, exercise, meditation, etc. While this may sound like a mild approach to dealing with this disease it is in actuality, anything but, and involves a quite rigorous application of a treatment plan, the details of which I would be glad to share with you, if you so wish. While Dr. Y did not endorse my plan she accepted that I was going to pursue it and wished me well, agreeing to monitor my progress with the understanding I could still go to her treatment plan, the use of the drug MethotreXate if improvement did not take place.

After adopting this treatment plan, I experienced “dramatic improvement” (Dr X's words) in the two weeks between appointments with Dr. Y. I was therefore eager to meet with her again and share the good news. Particularly, as Pityriasis Rubra Pilaris is considered a disease for which both the cause and the cure are unknown. Much to my dismay, Dr. Y neither recognized the improvement so obvious to me, and Dr. X, she was also unwilling to call Dr. X and verify his observations or review pictures he had taken that proved the improvement had indeed taken place. Again in Dr. X's words “the pictures don't lie”. Instead she strongly urged me to change course and go on Methotrexate a drug, which as you know, has very serious side effects, has, at best, inconsistent results and is not considered a cure. Upon my declining to change to her plan, we agreed that I would not continue to see her.

The purpose of this letter is to determine if Dr. Y's approach in this case reflects departmental policy or if, perhaps, there are others in the Dermatological Department more open to learning about a safer approach to treating this disease that appears to be working, with the further opportunity, thereby, of offering it to other patients now or in the future who seek treatment from Johns Hopkins.

Thank you for your time in reviewing this matter. I look forward to your response.  


Sincerely,