Dermatologist Recommendation

[OnMyWay]

(Wow, this turned into a long story!  Sorry!)

 

I had posted before that I was having trouble finding a good dermatologist here.  There are only 3 or 4 in the Subic area.  I went to one for a while but she was very limited in her skills and knowledge.   I asked her a few questions about modern treatments that I had heard of, her reply was simply "I don't think those are available in the Philippines".  Almost like the standard "out of stock sir" reply in retail, if they don't know where something is!   :hystery:  The others I eliminated by driving by their offices or finding information about them online.  If they don't care enough to put up a good office, I don't care to visit.

 

I did some research and I found that some hospitals in Manila did have capabilities.  Strangely, I was searching for "sleep dentistry"  (for my daughter) when I ran across a clinic in Angeles City that is a cosmetic oriented medical clinic as well as a dental clinic.  The head guy is Dr. Tan, a dermatologist who specializes in laser treatments.  He did his laser training at Harvard Medical school and he seems to be a very sharp guy.  Very knowledgeable about the skin subjects we talked about, and I have talked to several dermatologists in the past 20 years.  His office is clean and modern, nice staff, and he has what appears to be very modern state of the art equipment.  I don't know who the dentist is but there are some good recommendations in the link below, and I saw one dental treatment room that was also top notch.  I might give the dentist a try after I ask about it.  I am not sure if this is good or not, but in the 3 visits I have made,  ALL of the other customers I have seen were foreigners.

 

I had one major problem on my cheek that has been ongoing for about 3 years, and the treatment seems to be working.  I won't go into the details on that one right now but I am happy so far.

 

For the more mundane stuff that you old farts like me suffer from, also very good.  Many of us have spent too much time in the sun and now we are paying the price.  In the past, I have had pre-cancerous spots and basal cell carcinoma's removed by scraping, burning, freezing and even one Mohs surgery.  The laser replaces most of those.  He also can do Mohs surgery but I think it is not used much as the laser can probably do it.   He did 3 spots on me.  It was quick, accurate and clean.  He gives you a minor local anesthetic at each spot.  The laser cauterizes the wound immediately so it is like you have a scab immediately.  You don't even need a band-aid unless the location calls for it (like on my foot).  By comparison, those other methods above are very messy and will leave more scarring.

 

Cost?  First consultation, p400.  Laser treatment session:  First big one on my cheek, p2000.  Second one on the 3 spots.  P2000.  I think that the basic laser session is p2000 but if you had a lot of places to treat it might be more.  That is a lot for a local person but for me it is a bargain after experiencing the other options.  I know he has put out a lot of money for his equipment.  I also bought some meds from him, and his prices were almost the same as Mercury.  I asked at Mercury after the fact.

 

I haven't finished my treatment yet, so I will not give him a 100% recommendation yet, but I like the place a lot.  Maybe there are some other guinea pigs in the area that can check it out.  He can remove those old tattoos for you!  You can finally get rid of the ex's name on your bicep or the "I Love Mom" on your azz!   :hystery:   Here is a link to information about the clinic:

 

http://www.whatclinic.com/dentists/philippines/angeles-city/britannia-medical-dental-and-cosmetic-center/sedation-dental

 

I'll finish with an old story.  In 2011 and early 2012, I was living in Kentucky before I moved to PH.  I had health insurance through my employer but they kept raising the deductibles every year (especially for HSA, which I had), so our out of pocket was going way up (one reason I left).  I think my deductible was $5000.  In late 2011 I found a dermatologist and visited him, but I had already fulfilled my deductible for the year so I didn't pay much attention to the cost, because insurance covered all but $20 or something like that.

 

So I go for another visit in early 2012.  He froze a bunch of spots with liquid nitrogen.  He was very liberal with it and if anything looked questionable, he zapped it.  Probably 10 spots.  After waiting an hour in the waiting room, I was probably with him 10 minutes, 15 max.

 

A week or so later I get the bill, and I head to the office right away.  This can't be right!  I sat down with lady in charge of billing and she went over the bill with me.  I could tell she had done this many times before and was good at it.  "I'm sorry, it is correct.  That is what we have to charge".  Etc., etc.

 

Over $800 (about p40,000 back then) for 10-15 minutes with the doc!    :bash:  :bash:  U.S. healthcare is such a mess! Cha ching for the lawyers!  I had to pay the whole thing because I had not reached my deductible yet.

Edited July 14, 2015 by OnMyWay

[Gratefuled]

I don't know if what I had is the same as yours but I had a dark thick spot about 1/4 inch in size appear on the side of my face. It wasn't a mole or a wart so the next time I was in my family doctor's office, I asked him

He took a look at it, then took a scapel and scraped it off. He said he would have a biopsy done on it. He did and it was ok. I had an HMO at the time and all it cost me was the $10 deductible for the office visit. This happened about 10 years ago.

I've had another one appear on my face here in the PI and my wife tells me not to worry. That they are common as we get older.

What? Me worry? Actually, I am concerned so I check the internet for anything that I am curious about.

I've had what appear to be freckles appear on my body which I'm told are common also as we age.

[sonjack2847]

I don't know if what I had is the same as yours but I had a dark thick spot about 1/4 inch in size appear on the side of my face. It wasn't a mole or a wart so the next time I was in my family doctor's office, I asked him

He took a look at it, then took a scapel and scraped it off. He said he would have a biopsy done on it. He did and it was ok. I had an HMO at the time and all it cost me was the $10 deductible for the office visit. This happened about 10 years ago.

I've had another one appear on my face here in the PI and my wife tells me not to worry. That they are common as we get older.

What? Me worry? Actually, I am concerned so I check the internet for anything that I am curious about.

I've had what appear to be freckles appear on my body which I'm told are common also as we age.

In the Uk we call dark spots,on the skin, liver spots and they are quite common as we get older.

[OnMyWay]

I don't know if what I had is the same as yours but I had a dark thick spot about 1/4 inch in size appear on the side of my face. It wasn't a mole or a wart so the next time I was in my family doctor's office, I asked him

He took a look at it, then took a scapel and scraped it off. He said he would have a biopsy done on it. He did and it was ok. I had an HMO at the time and all it cost me was the $10 deductible for the office visit. This happened about 10 years ago.

I've had another one appear on my face here in the PI and my wife tells me not to worry. That they are common as we get older.

What? Me worry? Actually, I am concerned so I check the internet for anything that I am curious about.

I've had what appear to be freckles appear on my body which I'm told are common also as we age.

 

You just need to keep an eye out for anything abnormal.  If a spot changes shape or gets dark or starts bleeding, get it checked right away.  There are many different ways for skin cancer to transpire.   It is very easy to remove them when needed, even with the old methods, as long as you don't let them go too far.

 

I had a tiny spot (maybe 1/8 inch) on my face that was bleeding in the early 2000s, when I lived in sunny Florida.  My regular dermatologist tested it and it came back positive, and it was the more serious type of skin cancer, melanoma, not basal cell.  He sent me to a Mohs surgery specialist.  I read up on Mohs and the selling point is that they only cut away what is needed.  So I get it done and surprise, surprise, the cut was about 1 inch long with several stitches!  It left a nice scar but it has slowly faded over time.  Moral of the story:  Don't postpone!

 

I'm fairly certainly that a laser could have done a much better job.  They would just burn in around the 1/8 inch area, as deep as needed, and not have any big cuts.

 

Another thing I did not mention.  The place on my cheek that is a a big problem now, started out as a small scaly place about 1/4 of an inch wide, in 2012.  My expensive dermatologist in Kentucky told me not to worry about it, but he would freeze it it I wanted to.  I chose not to because it was on my face and freezing causes a big blister.  Bad choice!  It turned into a "lesion" that would not go away, despite a few steroid creams I got here in PH.  My GP here tested it last year and it was not positive for cancer at the time.  However, at some point it morphed and got basal cell carcinoma in it.

[earthdome]

Makes me feel fortunate that I have never been a beach person or one who wanted to lay outside and get some sun. Been wearing a hat when outside for almost 20 years now to protect my partly kalbo scalp.

 

Have been back in the states now for almost 6 months now. Was at a family reunion and found out that an ECG (echo cardiogram) now costs around $2500.00 in the US. My brother had one and is copay was $87 with great health insurance. In Baguio I only paid $70 for the same. So the full price was less than his copay.

 

I also had an instance recently with my wife where we went to a specialist and associated hospital. Thought it was in network for my wife's insurance because it is in network for me and we have the same insurance carrier but different policies. Turns out it was out of network. Cost for a very short ultra sound, blood work and a doctor visit was over $1000. I went back and talked to billing and negotiated it down to 45% of the original bill. Still, this would have only cost $50 in the Philippines.