(To access patients in outlying areas, Derm Health has offices in Bend, Redmond and La Pine | Photo courtesy of Dermatology Health Specialists)
Dr. Oliver Wisco, an Oregon native who spent 27 years in the U.S. Air Force — including time as a medical dermatologist and Mohs surgeon — went “kicking and screaming” to Mississippi for his last assignment, confident that once it had ended, he would return to academia (where he had studied and taught at such prestigious institutions as Harvard, Emory and Tulane University’s Schools of Medicine).
Upon arriving in Mississippi, he met a 22-year-old single mother (who was living with her own mother while raising an infant daughter) with advanced-stage melanoma. This patient radically changed Wisco’s professional direction.
As Dr. Wisco explained, “Suffering from a skin eruption, the patient was advised to use light therapy to treat her condition. As this option was not available locally, she chose instead to frequent local tanning salons over the next several years. Nearly a decade later, the woman developed a large mass on the side of her neck next to a rapidly changing mole. Unfortunately, her melanoma was very aggressive, and — lacking access to a large medical center with more advanced options — she subsequently died.”
As a result of that experience, said Wisco, “I told myself, ‘We have to do a better job of reaching these populations to educate them on how to prevent skin cancer. And if cancer does occur, we need to get to them early, when their cancer is treatable.”
Far from being deterred by the challenges involved, Dr. Wisco made healthcare performance improvement the foundation of both his local clinical work and national research efforts.
He chose Bend to launch Dermatology Health Specialists (Derm Health) in 2019. As Dr. Wisco explained, “rates of skin cancer are the highest in the world in Central Oregon, and rival those in Australia” — where two out of three Australians are diagnosed with some form of skin cancer during their lifetime. “I see much more frequent skin cancers here than anywhere else I’ve practiced.”
Given this alarming scenario, and in line with Derm Health’s commitment to “get direct access to high-risk and underserved populations and provide them with high-quality care,” offices were subsequently opened in Redmond and La Pine “to expand the reach of our services to communities such as Madras, Lakeview, Burns and John Day — where the drive into our offices in Bend can deter patients from seeking the comprehensive services we offer. The key is being where people need us.”
What is it about Central Oregon that contributes to such high rates of skin cancer? “Although certain risk factors have been identified for skin cancer — including access to care and early intervention, genetics, environmental exposure, certain medications, lighter skin, and outdoor work — data that tracks the relationship among these factors is lacking,” Dr. Wisco said.
Describing skin cancer as a “disease of healthy people,” he pointed out that many of those who move here are drawn by the active, outdoor lifestyle that puts them at greater risk. “Yet ironically, these same people do such a good job of avoiding heart disease by being active.”
“Cultural beauty standards are quite challenging,” Dr. Wisco said. “The number one killer for middle-age women is breast cancer, with melanoma ranking second. Yet while patients claim that they’ll do ‘anything I can’ to minimize their risk of breast cancer, the appeal of having a ‘healthy tan’ is difficult to overcome. That ‘glow’ reflects DNA injury to the skin — there is no such thing as a safe or healthy tan,” he emphasized.
Wisco identified lack of awareness as another barrier to skin cancer care. “You can bet that many of the people floating down the Deschutes River on a summer’s day aren’t wearing sunscreen or protective clothing,” he cited as an example.
Noted for his “energizer bunny” persona, Dr. Wisco continues to seek ways to mitigate these barriers, improve care practices, and promote overall health. Among them, he advocates:
Education aimed at the general public; regional screenings; utilizing virtual medicine as a diagnostic tool when in-person visits are not feasible; breaking down barriers in the medical system so that, for example, primary care physicians — who are “exceptionally busy” — can more easily utilize the expertise of dermatology specialists; and improving access to early intervention. Underpinning them all is, in Dr. Wisco’s words, “developing a health care system that accommodates the needs of patients,” and integrating long-term efforts to do so.
“Central and eastern Oregon have amazing clinicians,” he said. “We’re all striving to do the same thing — help our patients — and by working together across specialties, we can provide even better care.”
Toward that end, Dr. Wisco has been heavily involved in healthcare improvement initiatives primarily through the American Academy of Dermatology (AAD), the American College of Mohs Surgery (ACMS), and the American Medical Association’s National Quality Registry Network (NQRN). Most significantly, his efforts guided the development of the AAD’s national performance measurement system and data registry (DataDerm).
These national affiliations, including a continuing relationship with Brown University, where Dr. Wisco is an Associate Professor of Dermatology, directly benefit Derm Health’s patients in Central and eastern Oregon. “That’s where my heart is,” he claimed.
To quote: “By bringing the latest research and innovations here, and by maintaining a strong focus on personalized, patient-centered care, the Derm Health team ensures that their patients receive the most advanced, evidence-based treatments in a local, supportive setting.” Dr. Wisco has personally selected all five of Derm Health’s providers for their dedication to the same mission.
“We want patients to feel that we truly care for them,” he said, “so kindness and compassion are our top priorities as we help find ways to solve their problems, and make a difference in their lives.”
He added that “I think the world of the people on Derm Health’s medical team — it’s one of the best I’ve ever worked with in my career — hands down. I couldn’t do what I do without them.”
