In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe–others unsung heroes. All of these colleagues have much to share, from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.
Charles E. Crutchfield III, MD, is a graduate of the Mayo Clinic Medical School and a clinical professor of dermatology at the University of Minnesota Medical School.
Dr Crutchfield has appeared on the cover of multiple national medical publications that focus on the business side of medical practice. He authors a weekly newspaper column on skincare, hosts a monthly radio program on skin issues, and appears quarterly as a skin expert guest on a local award-winning cable television program. Dr Crutchfield is the coauthor of a children’s book on sun protection, a dermatology textbook, and recently published a smartphone app for primary care physicians. He has won numerous University of Minnesota Medical School teaching awards, including Clinical Faculty Teacher of the Year. Dr Crutchfield is also a professor of biology at Carleton College. He is a member of the AΩA National Medical Honor Society and an expert consultant for WebMD and CNN Health. Dr Crutchfield has also received the Gold Triangle Award from the American Academy of Dermatology, the Physician Health Care Hero Award from Medica/KARE11 news, and is a recipient of the Karis Humanitarian Award from the Mayo Clinic School of Medicine.
Dr Crutchfield is recognized as one of the nation’s leading authorities on skin of color. An active member of the community, Dr Crutchfield was recognized by NBC News’ TheGrio.com as one of the Top 100 Newsmakers Making History in the United States. He is also a founding member of Doctors for the Practice of Safe and Ethical Aesthetic Medicine (www.safeandethicaldoctors.org), a nonprofit organization.
An avid sports enthusiast, Dr Crutchfield is the team dermatologist for several professional sports teams in Minnesota including the Twins, Vikings, Wild, and Timberwolves.
Q. What part of your work gives you the most pleasure?
A. I just feel extremely fortunate to possess a skill set where I have the ability to solve dermatologic problems. As physicians, I think we forget that everyone is presenting with a problem that is very troubling to them. They took the time to make the appointment, wait for the appointment, drive out to see you because they have a life-affecting problem, and they need help. I feel so good inside when I am able to help a patient with a dermatologic concern: It can be anything from removing the terrible irritation from an itchy skin condition like eczema to raising self-esteem by clearing up bad acne and/or psoriasis and vitiligo. It makes the effort all worthwhile to see the increasing self-esteem of a patient after an aesthetic procedure erasing unwanted frown lines that make a person look angry. The field of dermatology is filled with opportunities to make a difference in our patients’ lives. I feel fortunate to be part of that profession.
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. As a graduate of Carleton College with an undergraduate degree in liberal arts, I see every day how important the humanities are. The study of art, philosophy, literature, and history are so important in my interactions with patients because I treat patients, not diseases. I think being well-rounded and having an appreciation of the humanities aids in one’s ability to be humane and kind to patients, which lead to an overall better experience for all involved.
Q. What is your greatest regret?
A. My biggest regret is that I have not been more involved with both the local state and national medical organizations such as the American Medical Association, the Minnesota Medical Association, National Medical Association, and the Minnesota Dermatologic Society. I especially regret not working to prevent the complete and utter harassment of physicians that has become prevalent over the last 10 years. The impositions and burdens placed on physicians are unfathomable to earlier medical professionals, as shown by the implementation of ICD-10 (there’s an ICD-11 already ready to go, no less) and documentation of electronic records. It is hard to believe any other category of professional would allow such interference. When I hear about things like a code for injury resulting from a fall from a spacecraft, it deepens my regret that I did not fight harder within those organizations to protect physicians more. n
Q: Who was your hero/mentor and why?
A. This is easy: Both of my parents. They are both physicians and graduates of the University of Minnesota Medical School Class of 1963. My mom became pregnant with me during her first year in medical school, so I was 3 years old when they graduated. One of the few children of a medical school student, their classmates got to know me well. In fact, a few years ago I got a call from a physician who wanted me to remove a biopsy-positive skin cancer, and he told me that he and I had attended medical school together. I did not recognize the name, but when he came in, I realized that he was at least 20 years my senior. He laughed and told me that as my mother’s lab partner during anatomy class while she was pregnant, he would sit looking at her stomach. So in a sense we did go to medical school together. My mother was both the first African American woman to graduate from the University of Minnesota Medical School and at age 22, was then the youngest graduate in the University of Minnesota Medical School’s history. My father was the first African American obstetrician-gynecologist practicing in the Twin Cities, and even at age 76, he continues to see patients 2 days a week. He has delivered over 10,000 children in the metropolitan area. Not a day goes by that I do not see a patient one of my parents has either taken care of or helped greatly. Carrying the same name has made it very easy to practice medicine in the same city, and I am so very proud of both of them.
Q. Which patient had the most effect on your work and why?
A. Since I started practicing, I have learned a lot from patients and continue to do so on a daily basis. I do remember a 13-year-old girl who had extensive vitiligo, and her mother was inquiring about Benoquin (monobenzone), a topical agent that would bleach away the dark patches of her skin. I thought to myself, turning someone whose normal skin color is chocolate brown into essentially an albino white person might not be the greatest treatment for vitiligo. But I remember the girl looked at me with tears in her eyes, and she said she was teased incessantly in school and in social situations like going to the mall and movies. She said, “I don’t care what color I am. I just want to be one color so I don’t feel self-conscious.” I learned a lot from her.
Q. What is the best piece of advice you have received and from whom?
A. One of the best pieces of advice I have gotten came from my father. He told me anytime I receive a signed records release form from a patient that indicates they are going elsewhere to seek the services of a different dermatologist, I should not to take it personally. He said oftentimes there are other circumstances—sometimes multiple issues and reasons—that necessitate the change, and many of those times they are related to geographic, financial, or insurance coverage issues. He said you will be surprised that many times they will show up years later. His advice has been spot on.
Q. Which medical figure in history would you want to have a drink with and why?
A. There are so many people, but in medicine I would select Bernie Ackerman, MD. Dr Ackerman was a stellar dermatologist and dermatopathologist who, although controversial, was extremely bright and always had insight into dermatological disease and treatment. Even though he and I coauthored a dermatology textbook with several other dermatologists when I was early in my career, I regret that I did not have more interaction with him later as I developed my dermatologic skills and practice.
Q. What is the greatest political danger in the field of dermatology?
A. One of the biggest political dangers for dermatologists is an insane maintenance of certification that is both intrusive and cumbersome. It does nothing to provide a higher quality of care to patients. What we want to do is make sure doctors are staying up-to-date with continuing medical education. In contract, these crazy exams have no relation to quality of care and do nothing but generate money for certifying organizations. It is a shame that physicians have to go through this. I am strongly behind the current movement most dermatologists favor for the maintenance of continuing medical education for improved patient quality and care.