When I saw a recent New York Times article and video about a tattoo artist that focuses on realistic nipple tattoos for women who have had cancer related breast reconstructions, I was skeptical. We certainly don't normally see a tattoo artist as part of the continuum of care or part of our community of medical providers, and I would have some hesitations about recommending this kind of post-surgery tattoo outside of the context of the surgeon's office.

I will say that while I have done nipple reconstruction, augmented by tattooing, since breast reconstruction started in the 70's, I have often wondered if the tattooing could not be done better by a tattoo artist. As a physician and surgeon, and student of anatomy, I have an appreciation of reconstruction, meaning restoration toward normal, its principles and indeed, its art (as is demonstrated in this tattoo artist's work). Nipple reconstruction is more than application of decoration. I also knew about the blood supply of the breast, where the implant may be working, and a surgeons commitment to sterility.

However, I also wondered, often, could more practiced hands and heavy duty equipment give a more long-lasting result, despite the fading all tattoos are subject to. I respect the commitment of this artist profiled in the article. Also, I have used medical tattooing as alternatives to things like eyebrow reconstructions.

So, what does this have to do with medical collaboration? Everything, actually. This tattoo artist may not be a traditional member of the medical team, and I might some recommending this to a patient, but in this case, he is certainly providing care related to the healing process. How much of a smoother process would it have been if he could have used iClickCare (as one example of a telemedicine-based medical collaboration platform) to communicate with the patient's surgeon? How much less would her wait time have been? How much more confidence would she have had that this was an appropriate course of action and would fit in with the rest of her treatment? How many potential medical issues could be avoided if the traditional medical providers were able to share their information with the folks supporting the patient with less traditional medical issues?

As medicine shifts, so does the team of medical providers. Our job is to make sure that we have the tools to collaborate with every member of the medical team, traditional or nontraditional.

Of course, it's crucial to have a medical collaboration tool that allows you to respect HIPAA and communicate in a way that honors the patient. We've found that this means you need to be able to have a virtual consult that may "pick and choose" what information, pictures, or history that particular collaborator has access to. So this kind of collaboration is certainly to be handled with care, but as medicine evolves, I believe it is absolutely crucial to involve all members of the team caring for the patient. In this case, the person in question is a tattoo artist, but in so many other cases, the continuum of care for a given patient could include people like:

• Acupuncturists
• Therapists
• Teachers
• Caregivers
• Family
• Lactation Consultants
• Etc.

Have you found the need to do medical collaboration with any nontraditional parts of the team? How have you facilitated communication and collaboration with them? We'd love to hear, in the comments below.

And for our "field guide" to medical collaboration, click here: