Bermudians who travel overseas for medical treatment which is available in Bermuda. Some people do seem to travel for relatively simple procedures or simply for physicals which could be carried out locally.

This is not very flattering to the local medical fraternity and it does not increase confidence in the King Edward VII Memorial Hospital which is, after all, a good small general hospital. People who go abroad unnecessarily also increases the insurance premiums of those who stay home for treatment because they subsidise the high costs of treatment in the United States.

Some people travel because they believe that treatment is always better abroad but that is certainly not always true. However others travel because over the years they have become suspicious that local doctors operate a closed shop which does not always give full consideration to the patient or put the patient first.

Certainly there are gaps in the specialist treatment available locally and there are suspicions that local doctors undertake procedures for which they should be better qualified. There is always the belief that locally you might get a "make do'' treatment when abroad you will get a doctor who is highly qualified in a specific field.

Some of the suspicions are justified but many are not and Bermuda is probably much better served by medical expertise than any other place of comparable size. But suspicions are encouraged to continue because of obvious gaps in locally available specialists.

The gap most often complained of to us is the lack of a full time and well qualified dermatologist or skin doctor. It is true that there is a specialist who visits regularly but that does not seem to be adequate for a country of outdoor livers in a hot and humid climate.

Some skin cancers are notorious for fast development and if a specialist is not readily available you could be in very serious trouble before the doctor next comes to visit. This is of great concern to a significant number of people in the community yet the situation is allowed to continue.

We hear all kinds of excuses, from keeping the place open for Bermudians in training to the claim that a visiting specialist is enough. We doubt that either is a valid excuse and we suspect that this might be an instance of doctors attempting to hold on to patients by operating a closed shop with the agreement of the Department of Immigration.

But the truth is that the lack of a dermatologist is not fair to the people and it is increasingly obvious as a need which is not being filled.

We think the situation should be corrected, and quickly.