Within these two decades, the medical world has dramatically been unveiled in Japan.
Now there are lots of medical stories like comics, novels, TV dramas and movies, as well as numerous websites and TV variety shows containing professional informations.

When I was a child (about 40-30 years ago), ordinary people could not know inside head of doctors while they diagnosed and treated patients.
I could only looked into the medical world through one such comic entitled "Black Jack", episodes of a crackerjack surgeon drawn by a real doctor, Osamu Tezuka.

However, now several real doctors write there inside stories in novels. Everyone can access to the newest professional medical informations via internet or TV.

Since people can choose medical institutions rather freely in Japan, atopic dermatitis (AD) patients became the talk of changing their dermatologist one after another, called "Atopy Gypsy".
Could the public informations make them more stable?

No, I still see many AD patients change their dermatologists frequently.

However, now they investigate clinics or hospitals via websites and SNS talk before they decide where to go.
So, they should have chosen some therapeutic ways they preferred.

Although they chose the dermatologists by themselves, they left them soon.
When they visited them, probably they would have not been satisfied.

Can they find a suitable dermatologist at last ?
No, many AD patients who visit dermatologists won't write down all too many past clinics they went.
Why are they wandering?

The reason why will be that their AD continue.
As today's medicine has no radically curable treatment for AD, their AD recur sooner or later.
Then the patient intend to go to another dermatologist because his/her AD was not cured at the previous one.
Maybe they wish to be cured this time.

Another reason may be insufficient improvement of symptoms or concern to adverse effects of the treatment.
When AD is raging, it often beyond control.
To keep control AD symptoms, patients must frequent dermatologists to get prescriptions.
Also many Japanese patients are familiar to adverse effects of corticosteroids including dependency or addiction, they often tend to seek another options.
But if they avoid topical corticosteroids, they have to make alternative efforts to control their AD.
Even if they choose any treatments, they are still in trouble most of the time.

And additional reason could be about emotional impression of the dermatologists.
They want to be heard their daily difficulties closely, treated kindly and explained fully.
Indeed, doctor should listen to patients' anamneses carefully and explain how to treat them.
Sickened weak people must be treated gently.
In fact, some medical staffs are annoyed by difficult AD patients and might throw them harassing words.

Any reasons above, I think, would end up to the incurability of AD.
AD patients change their dermatologists because they have not cured at them.

Any treatment might have some risk of adverse effects.
So, doctors prescribe necessary and sufficient medicines to patients and have to continuously monitor and adjust them depending on their progress, always intending maximum results and minimum adverse effects.

Both dermatological doctors and AD patient should make such efforts until recovery.
In case of AD, sadly the recovery is not promising and the efforts might often not be rewarded.
The hard process will be endless !
So stressful, but this is the fact.

If AD patients require "medicines which never produce any ill effect" or "treatments which definitely lead them to cure" of their dermatologists,...
If AD patients expect such explanations as "how to use corticosteroids producing no side effect" or "a reliable prospectiveness when their AD surely improve" to their dermatologists...
then, any expert dermatologist can not satisfy their anticipations.

Day after day, AD patients are stressed out by their incurable disease process.
Hardness due to AD symptoms, difficulties of daily lives and social problems including lack of understanding concerning AD are all stored up as resentments.

However, there are not much vent for such frustrations.
They rather have to hung on in their office or school.
Their family and friends might be confided, although there are limits.

Actually, it may be natural course patients find vent at doctors.
I remember a dermatologist once followed up lots of AD patients who avoid topical corticosteroids treatments wrote "The patients come here to throw of their tears."

Dermatological authority also pay attention at AD patients' mentality recently; the diagnostic and therapeutic guideline of AD by Japanese Dermatological Association refer to it.
However they only see the aspect mental stress worsen AD symptoms, but ignore mental stress due to worsening of AD.

It's true doctors should hear of patients with care and affection.
However, physical doctors are too busy to talk long with each patient.

Though AD patients often blame dermatologists for incurability of their AD, it is not the physicians' fault.
Should dermatologists take care all of AD patients' daily lives and mental health instead of incurability ? __ No.

Of course, dermatologists themselves also have to be humble.
As far as today's standard AD therapy cannot bring the exact relief to most of AD patients, it is not a single right answer.
I don't think corticosteroids as harmful medicine, nor AD patients who avoid corticosteroids as groundless steroid-phobia.
Any efforts for AD alleviation should be justified.

Moreover, sometimes dermatologists in authority speak ill of other physicians the AD patients previously went to.
Patients will be more distressed by the idea that their past days were the failure......

.......In year 2015, I met many patients who complained their discontents over their medical process.

Patients grumbled various dissatisfaction over previous physicians, just like physicians disparaged former ones.
Some patients pressed doctors for cure.
Some patients claimed doctors to take responsibility of incurability.
Part of them even looked like living with the grudge as mental nourishment.

However, as I wrote above, nobody can resolve their resentments until their AD end.
Even if a dermatologist take much time and hear his/her long long story to soothe him/her, the anxiety will come back soon provided his/her real AD remains.

I play for them not to live in rage.
Resentment is fruitless.

Dermatologists are not the enemy of AD patients.
They stand by the patients.
Within the comrades, goodwill will be fit than hatred.

I believe attacking each other is by no means productive.
Don't you think dermatologists get hurt by their patients' words just like patients feel wounded by dermatologists' words ?

Please keep up the freedom of your heart though illness deprive you of your physical freedom.
I'd like to meet such free-minded patients in my days of dermatological and alternative therapeutic practice in 2016.

Happy new year !

2016.1