“Geneva is beautiful. The whole of western Switzerland is beautiful. It has two beautiful university cities with – not quite so beautiful – university hospitals,” says Prof. Wolf Henning Boehncke, head physician of dermatology at HUG, about his location. He reports with a twinkle in his eye on the love-hate relationship between Geneva and Lausanne.
On the occasion of the 100th anniversary of the SGDV, it should be noted first of all that the professional society was born in Geneva, precisely on April 24, 1913. Those interested in details will find them in Edgar Frenk (Dermatologie und Venerologie in der Schweiz. A historical review. Edition Alphil 2004). At that time, Geneva’s medical school was just 37 years old, and the dermatology department had been in existence for 24 years. The centennial history of the SGDV was decisively shaped by the five Geneva Ordinaries Oltramare (1889-1926), Du Bois (1926-1946), Werner Jadassohn (1946-1968), Laugier (1968-1982), but above all Saurat (1982-2009). It was Saurat who initiated the establishment of the Swiss Network for Targeted Therapies (SDNTT), a registry that is now well networked across Europe to document psoriasis patients treated with biologics. As a psoriasis expert, I may owe my appointment in Geneva to the biologicals, the SDNTT and Jean Hilaire Saurat…
Competition stimulates business
Geneva is beautiful. The whole of western Switzerland is beautiful. It has two beautiful university towns with (not so beautiful) university hospitals. The almost gleefully cultivated love-hate relationship between the sites is also not quite as nice. Here as there, this almost loving care of the competition shows: people look to each other because everyone knows how much, not least, good patient care depends on both sites functioning.
Sometimes friction is inevitable, for example when a contemporary of the “Geneva” Saurat is the “Lausanne” Panizzon. Hard to imagine that two giants come along peacefully-apart in shoulder-to-shoulder!
Cooperation is required
Times have changed: As a result of the change in economic conditions, skin clinics in particular have been condemned to shrink. And the climate within clinics calls for a new generation of “bosses.” One may mourn the charismatic “grand old men” (and so do I!), but increasingly team players (not to be confused with conformist yes-men!) who seek to work together are now in demand.
In Bern (Borradori), Geneva (Boehncke), Lausanne (Gilliet) and Zurich (French), there are four full professors in office who belong to the same research-oriented generation, supplemented by Professor Itin in Basel, who is known everywhere as a cooperative person. All five sites have committed to REAL cooperation. First “products” are the already mentioned national registry for psoriasis therapy with biologicals (SDNTT) as well as joint trainings by using an innovative internet platform (DermArena).
Très Grands Colloques
However, the possibilities and plans between Lausanne and Geneva go much further: In the field of research, psoriasis is an interface where both departments (Lausanne – basic research; Geneva – translational research) complement each other perfectly. In teaching, the goal is to give residents the opportunity to fulfill the FMH’s ambitious continuing education catalog in the best possible way through concrete clinical collaborations. In addition, the dates and topics of the Grands Colloques will be increasingly coordinated, and from 2014 there will probably also be joint “Très Grands Colloques”. Hard to believe: something like this already existed, under Saurat and Panizzon (!).
Specific resources
However, the potential in the field of patient care is particularly large (and important!): After the shrinkage of the last years, top competence in as many sub-specialties of our multifaceted subject as possible can only be achieved for the patients of Western Switzerland through optimal cooperation. In addition, there are specific resources that exist a priori only at a few locations. For example, Geneva Dermatology has two photopheresis units that are used intensively. In addition to patients with lymphoma, this resource also benefits patients with graft-versus-host disease in particular; this underscores the importance of dermatology and its expertise beyond its own specialty. Currently still limited to a few individual cases, the Geneva hyperbaric chamber is also to be used increasingly in the future for hyperbaric oxygen therapy of dermatological patients with chronic wounds.
Outlook
And so, after a (against each other to) side by side, more and more a togetherness of the dermatology of Geneva and Lausanne is emerging. One thing is clear: the lovingly cultivated love-hate relationship between Lausanne and Geneva is charming, but best kept as a humorous passage in festive speeches. But a little bit of competition here and there cannot always be necessarily and inevitably harmful, can it?
Prof. Dr. med. Wolf Henning Boehncke
