By Abby S. Van Voorhees, MD, August 01, 2014
Playbooks are used in sports to demonstrate possible plays. They provide an orchestration of steps to get things done, recommending paths that often are successful. We in dermatology don’t use playbooks to lead our profession; in fact, we tend to balk at such rules. The fastest way to get a rise out of us is to say we all have to prescribe a certain medication or perform a specific task without opportunities for exceptions and nuances. Well, welcome to 2014. Industry has long realized the value of playbooks too. Medicine can’t afford to create new paths for every effort. Learning from others, allowing for more success, carries many advantages.
The history of tobacco legislation can be seen as a playbook. Back in the ’40s and ’50s tobacco was promoted by industry as safe and cool. My husband, growing up in rural North Carolina tending the tobacco fields, remembers his grandfather scoffing at anyone who’d smoke after handling the crop — the tar stuck to everything. He didn’t need an advanced degree to know that smoking was not safe. After decades the tobacco industry was forced to acknowledge what others had long been saying, that cigarette smoking was a health hazard. While it took years, the effort was a success. It created a playbook on how to change the public’s views and force the government to see risks for what they were. Fast forward to the last decade or so. One of our features this month talks about what’s going on with tanning legislation, dermatology’s baby. The tobacco playbook gave us guidance on how to move the ball forward. Those of us old enough to have lived through the ’60s, ’70s, and ’80s recognize the arguments of the tanning industry trying to stop our momentum. The progress continues thanks to our playbook, lots of hard work by many of our members, and alliances with others...you are going to want to read this month’s piece on the tanning playbook.
I assume that you’ve noticed that the updated atopic dermatitis guidelines of care have been “rolling out” in the JAAD. I am unabashedly a champion of these documents. They provide guidance for care in dermatology so that we don’t have to research each topic ourselves. However, the atopic guidelines stand out for another reason. For the first time patients were actively involved in their creation and content. Patients, you ask — why include them? Well, it turns out that they contributed quite a lot according to the atopic dermatitis guidelines of care workgroup. Keeping us focused on what matters when you have a disease is key given our current environment with diminishing research dollars. And who better to know what we need to focus on than someone with the disease? Part of the renewed emphasis on understanding itch came from our patients suffering with inflammatory diseases. I believe patients are going to be playing a much bigger role going forward. I guess that’s something we should have long known if we’d read other playbooks...be sure to involve all key players in any efforts to move things forward.
Frustrating to be hitting the end of my space; would have loved to have highlighted some of our other pieces too such as Cliff Lober’s piece on sexual misconduct and my interview with Loretta Davis on the potential skin cancer risk of nail salons. Only Alex Miller could make claim rejection interesting to read about! I’ll end though with a plug for our international piece providing a bird’s eye view into dermatology in France. I think that my next playbook should include a recommendation for a visit to get a closer look. Who knew I could be such a good rule-follower!
Enjoy your reading. See you in Chicago!