What Is in the Patient's Treatment Toolkit?
Why collaborative care begins before the next prescription.
The most important question may not be, “What should we prescribe next?” It may be, “What has this patient already experienced — and what are we missing?”
In clinical practice, it is easy for a patient's treatment history to become a list: medication tried, response inadequate, therapy discontinued, next option selected. But a list of prior therapies is not the same as understanding the patient's experience with those therapies.
A patient may arrive after seeing multiple clinicians, carrying a growing collection of prescriptions, samples, over-the-counter products, lifestyle recommendations, and specialist instructions. Some treatments may have been used exactly as directed. Others may have been unaffordable, poorly tolerated, confusing, inconvenient, or abandoned before they had a reasonable chance to work. Two specialists may even be addressing different manifestations of the same underlying condition without realizing that their plans overlap.
A Treatment History Is More Than a Medication List
When a chart says that a therapy “failed,” that conclusion can hide several very different realities:
Those are not interchangeable problems, and they should not automatically lead to the same next step. A new prescription will not solve an access barrier. A more potent treatment will not necessarily solve unclear instructions. Repeating the same therapeutic strategy under a different brand name may not help if the diagnosis or the patient's priorities have not been revisited.
Seven Questions to Open the Toolkit
A purposeful treatment review can begin with seven practical questions:
What has the patient actually used?
Include prescriptions, samples, over-the-counter products, supplements, procedures, lifestyle changes, and recommendations from every involved clinician.
How was each treatment used?
Ask about dose, frequency, duration, application technique, sequencing, and whether the patient understood the plan.
What happened next?
Separate lack of efficacy from partial response, intolerance, inconvenience, fear, cost, and inability to obtain the therapy.
Why was it stopped?
The reason a therapy ended is often more clinically useful than the fact that it ended.
What matters most to the patient now?
The clinician's priority may be disease clearance while the patient's priority is sleep, pain, hair loss, fatigue, sexual health, appearance, or the ability to work.
What else is being treated?
Skin findings may intersect with inflammatory disease, hormonal health, malignancy, medication effects, allergy, gastrointestinal disease, or other systemic concerns.
Who else needs to be part of the plan?
Sometimes the most important next action is not another prescription. It is communication with primary care or another specialist, clarification of responsibility, or a coordinated decision.
Shared Decision-Making Is Not an Extra Step
Shared decision-making brings clinical evidence together with the patient's values, preferences, circumstances, and goals. The Agency for Healthcare Research and Quality describes it as a collaborative process in which clinicians and patients work together when more than one reasonable option exists.
In dermatology and other chronic disease settings, that conversation is particularly important because effectiveness in a clinical trial does not automatically translate into success in daily life. Treatment burden can include time, monitoring, application complexity, appointments, expense, transportation, side effects, and the emotional labor of managing a visible or unpredictable condition.
The Patient Does Not Experience Care in Specialty Silos
Patients with complex inflammatory, autoimmune, hormonal, oncologic, and chronic conditions rarely fit neatly inside one specialty. A patient with psoriasis may also be navigating joint symptoms, metabolic risk, gastrointestinal concerns, or mental health effects. A patient presenting with hair loss may require consideration of dermatologic disease, hormonal changes, nutrition, medication exposure, stress, or systemic illness. A patient receiving cancer therapy may develop cutaneous effects that influence comfort, adherence, and quality of life.
When clinicians work in isolation, the patient becomes the messenger between separate care plans. That creates opportunities for duplication, contradiction, delay, and frustration. Collaborative care does not require every clinician to manage every condition. It requires each clinician to recognize where their decisions intersect with the work of others — and to communicate when those intersections matter.
From “What Is Next?” to “What Is Missing?”
A useful pause before prescribing is to ask:
- Do we understand why the previous plan did not succeed?
- Have we addressed access, affordability, tolerability, and treatment burden?
- Does the patient understand what improvement should look like and when to expect it?
- Are there comorbidities, concurrent medications, or specialty recommendations that change the plan?
- Have we included the patient's goals in the decision?
- Would communication or collaboration create more value than simply adding another therapy?
These questions transform the treatment history from a record of past prescriptions into a clinical decision-making tool. They also create a more respectful conversation. Instead of implying that the patient has failed multiple therapies, we investigate whether the treatment, the healthcare system, the communication, or the coordination failed the patient.
Bringing the Conversation to the Collaborative Care Summit
This is the kind of conversation the Collaborative Care Summit was created to advance. On September 12-13, 2026, healthcare professionals from dermatology, rheumatology, allergy and immunology, gastroenterology, oncology, women's health, primary care, and other disciplines will come together at the Hilton Orlando for interactive, case-based education focused on complex and overlapping conditions.
The goal is not simply to hear another series of lectures. It is to examine real-world clinical decisions, ask better questions, understand how different specialties approach the same patient, and leave with practical strategies that can be applied immediately.
Collaborative Care Summit 2026
September 12-13, 2026 | Hilton Orlando | Up to 10.50 CME/CEU credits
Learn More & RegisterEditorial Sources
- Agency for Healthcare Research and Quality. About Shared Decision Making.
- Agency for Healthcare Research and Quality. The SHARE Approach.
- van Cranenburgh OD, et al. Towards More Shared Decision Making in Dermatology: Development of Evidence-based Decision Cards for Psoriasis and Atopic Eczema Treatments. Acta Derm Venereol. 2020. PubMed PMID: 32812056.
- Eton DT, et al. A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers. BMC Geriatr. 2019. PubMed PMID: 31604424.
- Diversity in Dermatology. Collaborative Care Summit 2026.
Risha Bellomo, Executive Director
Risha Bellomo is the Executive Director of Diversity in Dermatology, bringing more than 30 years of experience across the healthcare landscape. She has witnessed firsthand the evolution of patient care—from siloed specialties to the growing need for integrated, collaborative approaches.
With a background spanning clinical practice, education, and healthcare business strategy, Risha brings a unique perspective on how systems, providers, and patients intersect. Through her leadership and industry partnerships, she is helping shape a more connected and inclusive future in dermatology.