When to Refer Out

  • Daniel M. Siegel
  • Laura T. Cepeda
  • Deborah F. MacFarlane


As physicians treating skin cancers, our training and experience vary. Regardless, many of us have the need and opportunity to perform varying degrees of skin surgery. The procedures we perform will be based on our experiences and particular areas of expertise, but for even the most experienced practitioner, there are patients whom one should refer out instead of treating. Deciding just which patients to refer out may be difficult and is a skill that is often acquired painfully through experience. It is our hope to provide some guidelines to aid in the decision to refer out so that one may avoid some potential medical, surgical, psychological, or legal headaches. The following will be written from the viewpoint of the Mohs surgeon, but hopefully there will be insights to be gleaned by anyone treating skin cancers.


Skin Cancer Plastic Surgeon Body Dysmorphic Disorder Body Dysmorphic Disorder Surgical Colleague 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



University of Wisconsin School of Medicine and Public Health for access to F.E. Mohs text, Chemosurgery in Cancer, Gangrene and Infections 1956. Charles N.S. Sopakar, M.D., Ph.D. occuloplastic surgeon, Clinical Associate Professor Ophthalmology and Plastic Surgery, Baylor College of Medicine, Clinical Specialist, Head and Neck Surgery. M.D. Anderson Cancer Center; Mark S. Chambers, D.M.D., M.S. Professor, Chief, Section of Oncologic Dentistry and Prosthodontics, Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Daniel M. Siegel
    • 1
  • Laura T. Cepeda
    • 2
  • Deborah F. MacFarlane
    • 3
  1. 1.Procedural Dermatology Fellowship, Department of DermatologyDownstate Health Science Center at Brooklyn, State University of New YorkBrooklynUSA
  2. 2.Haley Dermatology Group, Dermatologist and Mohs SurgeonFairhopeUSA
  3. 3.Departments of Dermatology and Plastic SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA

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