Thank you for the excellent synopsis about what MOHS surgery is about and
what it takes to do it right!!  Speaking from first hand experience I can
attest that many may try to "do Mohs" but only some are properly trained
Mohs surgeons. I work for one.  The 
difference being a true Mohs surgeon has undergone specific training in
this area-usually a year long fellowship.  Weekend courses in Mohs
technique or even short 1 to 2 week surgical instruction does not a Mohs'
surgeon make.  You are right-if it can be passed as Mohs esp. for insurance
purposes then it can be reimbursed at a Mohs rate and voila you have Mohs. 
NOT!  

Cure rates for Mohs are excellent-99% for basal cell carcinomas and some
what less for squamous cell carcinomas.  The accuracy and efficacy of the
technique speaks for itself.  But it must be done right.

Mohs done properly takes a trained surgeon and histotechnician who work
side by side and communicate each stage of the way.  Yes one Mohs surgeon
can have several cases going at once-in our case up to 3 OR's running and 3
Mohs cases ongoing with blocks being prepared by one technician.  It is not
that hard technically speaking just get your ducks all lined up in a row. 
Be organized, talk to your boss and do as he asks.  If you see a mistake or
make one-communicate to the surgeon.  It's fancy stat frozen sectioning
carried to a new level.  I like it and hope more techs get involved.  

The Mohs techs have a national society American Society for Mohs
Histotechnology  (ASMH).  The surgeons have their own national
group-American Society of Mohs Surgeons (ASMS)-I believe that's the correct
name.  The groups I and my superior belong to involve Mohs surgeons who
have had extensive training.  There is another surgical society and
technical society who do not have the same background training. The split
in the field is that controversial.  The ASMH and ASMS we belong to meet
annually in a different state each year-used to be in May now it is in
November.  Next meeting is set for late Nov. 2000 in Denver, Colorado.

Again, thanks for the mention of the field and an accurate description of
what it really is.  

Sincerely,

Sue Becker, HTL
Mohs Histotechnologist
c/o Dr. M. J. Mulvaney
Mohs Micrographic Surgeon
Albany, NY 12203  
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