A British dermatologist tells his story



    Alex Anstey

    Under the skin

    A dermatologist's fight to save the NHS, 350 pages. London: Whitefox Publishing Ltd, 2022. Price £9.99

    ISBN 978-19-150-3616-2

    Not many dermatologists write autobiographies. Alex Anstey is one of the few, and he writes well. Anstey is a former editor-in-chief for the British Journal of Dermatology, one of the world's leading scientific journals in dermatology, but he has also made a name for himself in research, medical education and health management.

    In this book, Anstey takes the readers on a journey from his time as a medical student and a junior doctor to his life as a consultant dermatologist both in and outside hospital settings. Many Norwegian doctors will be able to relate to much of what he writes. His ability to reflect on major and minor events and how they have influenced his own practice and career makes for a good read, even for those outside the field of dermatology.

    It is, however, wrong to say this is 'just' an autobiography, because it is about much more than the author. Each chapter begins with brief, apt patient vignettes. He tells the history of the National Health Service (NHS) and describes his own experiences with it – especially from his time in Wales, where he worked for many years. He probably did not actually 'save' the NHS, as the book's title may suggest, but he did manage to improve the health services in his field and was a source of inspiration for others. He reorganised the services to shorten the hopelessly long wait for patients to be seen by a specialist. His approach is close collaboration between primary and secondary health care, telemedicine and the use of digital photographs of rashes and skin lesions in all referrals. He also profiles some giants of Britain's health care in addition to lesser-known people who have inspired him, and who should inspire us all regardless of our specialty.

    Parts of this book have a quality reminiscent of literary descriptions of life as a doctor or vet in rural Britain. Other parts are too detailed and elaborate, and the gallery of characters is rather excessive for those not in the know. Nevertheless, for doctors who are Anglophiles and struggling with the organisation of specialist health services, this book may well be worth a read.


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