By Dirk Elston, MD, June 03, 2013
It has always been important for dermatologists to have a good relationship with our colleagues across medicine. But in this time of health care reform and reimbursement pressures, it may be more important than ever for our specialty to build bridges with others. There are formal, institutional ways to achieve this. There are also, as I will address later in this column, actions that only you can take to build relationships that will keep our ties with the rest of medicine strong.
One of the key venues where the house of medicine gathers to deliberate on important issues facing our profession is the American Medical Association House of Delegates, which meets this month. Our AMA representation is determined in large part by the number of dermatologists who are members of the AMA and designate the Academy as their primary organization of membership. It is important that as many AAD members as possible join the AMA and that our sister societies all secure seats in the House of Delegates, as our representation there is what gives us official standing in processes such as CPT coding that affect our members.
Dermatology is represented by the Dermatology Section Council, which is the collective voice of dermatology in the AMA House of Delegates; members deliberate regarding the issues before the House and often vote as one to increase the specialty’s influence. They deserve our gratitude, and include American Academy of Dermatology delegates Andrew P. Lazar, MD, MPH, (the section chair), Cyndi J. Yag Howard, MD, (the section vice-chair), Jack S. Resneck Jr., MD, and Marta J. Van Beek, MD, MPH; our alternate delegates, Hillary Johnson-Jahangir, MD, PhD, Adam Rubin, MD, and Sabra Sullivan, MD, PhD; our young physician section delegates, Lindsay Ackerman, MD, and Seemal Desai, MD; and our resident and fellows section delegates, Jennifer Ahdout, MD, and Erica Dommasch, MD. They also include the American Society for Dermatologic Surgery Association delegation of Jessica Krant, MD, Chad Prather, MD, Anthony Rossi, MD, Divya Srivastava, MD, William Waller, MD, and Nita Kohli, MD; Society for Investigative Dermatology delegates Daniel Bennet, MD, and John Fenyk, MD; American College of Mohs Surgery delegate Michel McDonald, MD; Navy delegate Josephine Nguyen, MD; Army alternate delegate Nathaniel Milleta, MD; state delegates Billie Jackson, MD, Elizabeth Kanof, MD, Hazle Konerding, MD, Danny McCoy, MD, and Leah McCormack, MD; and Georgia Tuttle, MD, whose long service has led to her holding a position on the AMA Board of Trustees. [pagebreak]
Cooperation among dermatology societies, like that seen at the AMA, is critical to the specialty’s ability to respond to the challenges of the changing health care environment. In that spirit, the Academy now gives observer status on the Council on Government Affairs, Health Policy, and Practice to sister societies that have a dedicated health policy office or lobbyist. It is important for dermatologic societies to act in a coordinated fashion to avoid mixed messages and to project a stronger voice.
These organizational efforts to build specialty unity and collaborate with others in medicine are important, but they are made immeasurably more fruitful by the efforts of each of you. We are a small specialty; there are only 10,000 or so of us practicing in the United States and we represent less than 2 percent of practicing physicians. We tend to practice away from hospitals, making us less visible to our colleagues, and we risk being marginalized. Every interaction you have with a physician from another specialty is an opportunity for you to represent the AAD. If you see a referral quickly and return a helpful report and a satisfied patient to the referring physician, dermatologists are seen a great resource, interested in ensuring effective and efficient care. If you see patients in the hospital, volunteer in your community, or offer to help with free skin cancer screenings, those in the hospital and the community will see dermatologists as the sort of people who do those things. If we are perceived negatively by our colleagues, they may think of us more as a place to redirect the pain of any future spending cuts rather than as partners in ensuring effective health care. That will be bad news for our patients — and bad news for dermatology’s future. Each of us has opportunities to make a difference in how our specialty is perceived, and I extend thanks, on behalf of our specialty, to each of you who makes the extra effort to represent us well.