Now anyone is saying they "do" Mohs.
For the sake of my mom and maybe myself someday, I feel it's my professional obligation to set this record straight. If you are personally invested or have a relative who may need Mohs surgery for an invasive skin cancer of the face or body, I'm writing this to you.
Mohs surgery involves removing cancer in stages, layer by layer, while leaving as much healthy tissue as possible. This meticulous process is achieved by an MDS-board-certified specialized surgeon/dermatopathologist with a mastery of skin pathology, surgical techniques, and reconstructive procedures.
If I could be an ambassador of the American Academy of Dermatology, the American College of Mohs Surgery, and the American Board of Medical Specialties, I would like to address this question without bias: Why should you choose a fellowship-trained and board-certified dermatologic surgeon, rather than a plastic surgeon or dermatologist without fellowship training or did not pass the ABD-MDS board examination to perform your Mohs surgery?
My answer would be: Mohs Micrographic Surgery is an incredibly complex and specialized procedure. Only a minority who bill for Mohs services have completed an ACMS-sanctioned Mohs Fellowship and passed their MDS board examination, as of May, 2024 (2,433 Mohs surgeons have passed as of 2023 records). For some reference, just 87% of physicians in the United States are board-certified at all, and many less have fellowship training in any field. You don’t have to be boarded or fellowship-trained to be a good doctor, but, the skills and knowledge achieved set the gold standard, especially when we are talking about the best treatment for a growing cancer on your face, lip, nose, eyelid, ear, or genitals.
In the words of the American Board of Medical Specialties: “A dermatologist who specializes in Micrographic Dermatologic Surgery is expert in the management of patients with specific types of high-risk and complex skin cancers that are best suited to treatment with micrographic surgery. The procedure involves the progressive removal and examination of the cancer-containing tissue until only cancer-free tissue remains. This specialist also has expertise in reconstructive procedures to repair the surgical defects after the cancer has been removed.”
And, the United States Medical Licensing website: “Physician Board Certification Serves as a Mark of Distinction. While board certification is not required to practice medicine, it is a valuable tool for determining the expertise and experience of a physician in a particular field of medicine.”
Why go to the level of specialty fellowship and boards? Because “It is a credential that patients can rely upon when selecting a doctor for their needs. ABMS board certification encourages doctors to continue learning, fosters research and innovation in health care, and leads to improvements in health care practices.”
I did a couple of quick web searches for "Mohs Surgery," "Mohs Surgeons," and "Top Mohs Surgeons" in my area and I was as baffled and misled by the results as anyone could be. RealSelf listed "45 Mohs Surgery Doctors in San Jose, CA," and only one out of 11 on page one were fellowship-trained for Mohs surgery. I also check Yelp, and there were listed one out of 8 Mohs-qualified in the sponsored section, and four out of 11 on page one. Check the resources at the end of this post for a reliable source for checking credentials.
These are the fellowship-trained, ABD-MDS board-certified Mohs surgeons in your area: https://www.mohscollege.org/find-a-surgeon/, https://www.mohscollege.org/for-patients/why-choose-an-acms-surgeon
While plastic surgeons play a vital role in many types of surgery, when it comes to Mohs surgery for skin cancer, the specialized training and expertise of a fellowship-trained and ABD-MDS board-certified dermatologic surgeon are unmatched.
When choosing a surgeon for your skin cancer treatment, remember that the best outcome will come from a surgeon with the appropriate skills, training, and experience.
Stay informed and be your own advocate.
2021 ABD annual report: https://www.abderm.org/public/announcements/abd-2021-annual-report
ABMS: https://www.abms.org/board/american-board-of-dermatology/#abd-mds
ABD diplomates: https://www.abderm.org/diplomates
