I have a BCC that was about 1 centimeter (on the surface). It has been frozen off but I am now referred to a Mohs Surgeon. The Surgeon is affiliated with a teaching hospital. I have worked adult ICU as an RN and have seen things that have made me cringe when Interns, even with supervision, have participated (I have seen very good work also) too. What is the norm for Mohs Surgery Can I demand that the referred surgeon do all the work? Some surgeons appear magical while working, and the resultant scarring always seems better if the surgeon is very experienced.
Can One Refuse to Allow an Intern to Participate During Mohs Surgery?
Doctor Answers 7
Pick Who You Want to Do Your Surgery
You are the boss! If you don't want the intern involved in your care, tell the attending surgeon before your scheduled appointment and when you come in on the day of surgery remind him or her again. There shouldn't be any problem with this, and if there is, I would recommend that you have your surgery performed elsewhere. Some patients have preferences as to who performs the Mohs surgery or who performs the repair, and that is fine. I'm sure that the attending has heard this request before, and I'm sure he'll hear it again in the future.
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Mohs surgery at a teaching institution
If you are concerned with who will be your primary surgeon while a patient at a teaching institution, you should discuss these concerns with your surgeon before surgery. This is a common question and the attending physician will be happy to discuss and alleviate your concerns.
Mohs surgery in private practice vs. academic practice
You must understand that anytime you choose to have your care at an academic center or a physician affiliated with a teaching hospital, you may be asked if a medical student or intern may participate in your care. If you choose not to participate in training next generation of physicians, you should only get your care such as Mohs micrographic surgery at a private practice clinic.
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Mohs Surgery and Interns
If a patient is apprehensive about someone other than a physician performing Mohs Surgery on them, the patient always has the right to have the attending physician perform the surgery.
No interns needed during Moh's Surgery
It is your body and of course you have a choice who operates on you. It is extremely unlikey that an intern would do any work on you. Some Mohs Surgeons train fellows who have already completed dermatology residencies and have skin surgery skills. At the time of your consultation you are free to ask the Mohs Surgeon who would actually be working on you.
Yes, you can ask Moh's physician to do all the work
Yes, you have the right to ask the attending physician to do all of the work. I am a Mohs surgeon and there is a steep learning curve in terms of surgery. It takes a few years after fellowship for a diligent surgeon to become good at his craft. If the surgeon that you were referred to won't agree to do all of the work then you might have to consider switching.
Intern participation in Mohs Surgery
In principle, the Attending physician should be closely overseeing the work of their residents and interns. In practice, of course, this does not always occur. I am probably a bit biased regarding this matter since I regularly serve as an attending at a teaching hospital myself. You might consider discussing your concern with the attending physician. The bottom line though is that you have the right to demand that you be treated by the attending (supervising) physician only.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.