Trends in types of dermatology books available over the last ten years
Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. email@example.com
Shifts in interest toward cosmetic and surgical dermatology and away from medical and academic dermatology have been observed in recent years. We hypothesized that this trend would be evident in the types of books available for purchase from a major medical textbook supplier. Books published from 1998-2008 were categorized by type and statistical testing was performed to determine if this trend has been reflected in books published. The percentage of medical dermatology books decreased over time, whereas the percentage of cosmetic and surgical dermatology books increased over time.
In recent years, shifts in interest toward cosmetic dermatology and surgical dermatology and away from medical and academic dermatology have been observed [1, 2]. This has resulted in a substantial subset of dermatologists spending most of their time practicing surgical and cosmetic dermatology  and some non-dermatologist physicians choosing to practice cosmetic dermatology rather than their own specialty . These shifts have played a role in creating an increasing shortage of academic and medical dermatologists able to treat complex medical dermatology patients [1, 2]. This shortage of medical dermatology care has been associated with patients experiencing shorter wait times for botulinum toxin injections for wrinkles compared with patients with changing moles . We hypothesized that this trend would be reflected in the types of dermatology books available for purchase that were published from 1998-2008.
Sentry Surgical Supply, a website providing access to over 30,000 medical textbooks, was searched for all dermatology publications. Five hundred ninety-one titles were retrieved from the initial search. Non-book publications, books published prior to 1998, books not yet published, and non-dermatology books were excluded from the data set. After these publications were excluded, 469 books remained. These were categorized into medical, surgical, dermatopathology, pediatric, or cosmetic books. Basic science books and books that were general in nature or covered many aspects of dermatology were placed in the medical dermatology category. The Mantel-Haenszel Chi-Square Test, which evaluates trend over time, was used to analyze the association between category of book and year.
Table 1 demonstrates the number and percentage of books in each category by year. The percentage of medical books appears to be decreasing over time, whereas the percentage of surgical and cosmetic books appears to be increasing over time. Cell counts were small for pediatrics and dermatopathology books, and no obvious trends were seen. Statistical testing in Table 2 confirmed that the percentage of medical dermatology books decreased over time (p<0.05), whereas the percentage of books that were surgical (p<0.01) or cosmetic (p<0.05) in nature increased over time.
Our study demonstrates that the trend toward a decreased interest in medical dermatology and an increased interest in surgical and cosmetic dermatology is reflected in the dermatology books available through a major medical textbook supplier. This trend reflects that authors are less likely to write about medical dermatology and more likely to write about surgical and cosmetic dermatology.
A limitation to our study is that only books currently available through Sentry Surgical could be analyzed. Thus, our numbers do not necessarily reflect books published each year. It is possible that surgical and cosmetic books were deemed to be outdated faster than medical books and were no longer made available for purchase. Books currently available may be an indicator of consumer interest rather than books published.
Another limitation is that only one medical textbook supplier was used in analysis. However one of the authors (JW) routinely reviews medical textbook websites and felt that Sentry Surgical carries a wide variety and number of medical textbooks. Four other websites selling medical textbooks were reviewed, and the authors felt that Sentry Surgical had the widest selection of dermatology textbooks.
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3. Kimball AB and Resneck JS. The US dermatology workforce: a specialty remains in shortage. J Am Acad Dermatol. 2008 Nov;59(5):741-745. [PubMed]
4. Singer N. More doctors turning to the business of beauty. New York Times. November 30, 2006. p. A1.
5. Resneck JS, Lipton S, and Pletcher MJ. Short wait times for patients seeking cosmetic botulinum toxin appointments with dermatologists. J Am Acad Dermatol. 2007 Dec;57(6):985-989. [PubMed]
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