Beyond the vote: advocacy at all levels will shape dermatology’s future

From the President

Brett Coldiron

Dr. Coldiron is the Academy's current president.

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In the August issue of Dermatology World, you read about what your Academy is doing to protect the public from the dangers of UV exposure, particularly from indoor tanning beds. For years, the Academy has prioritized this issue — advocating at all levels for greater restrictions on indoor tanning devices and educating the public on skin protection. We have made great progress in our efforts to protect the public from UV radiation, and in the first six months of my term as your president we have achieved several significant milestones.

In May, the U.S. Food and Drug Administration finalized stricter regulations of indoor tanning devices — including a strong recommendation against the use of tanning beds by minors under the age of 18 — and raised the classification for tanning devices to a Class II level. Also, in 2014 four states have enacted legislation that restricts minors under the age of 18 from indoor tanning — bringing the total number of states that have an under-18 ban to 11.

Just recently, Academy Executive Director Elaine Weiss and I joined the U.S. Department of Health and Human Services’ Office of the Surgeon General and Centers for Disease Control and Prevention to issue a national call-to-action on skin cancer prevention. Most notably, the national call to action encourages everyone — all levels of government, public and private organizations, health care providers, and individuals — to raise awareness of skin-protection practices. This call to action marks a big win for dermatology and our patients, because not only does it echo the message that we tell our patients every day — UV radiation is bad for you — it emphasizes the need for everyone across sectors to work together and tackle this public health issue.

However, there is a missing link in the collaboration chain. You read in my April column that I met with White House staff to share my concerns that insurance companies have removed a large number of specialists — including as many as half of all dermatologists — from their networks in 20 states. To make matters worse, many of these revised provider directories list deceased, moved or retired physicians.

So the question remains: if Acting Surgeon General, Dr. Boris Lushniak — a dermatologist — is calling on the nation to work together on this public health issue, why are insurance companies creating an access issue for our sickest patients by removing the very specialists who treat skin cancer from their networks?

In addition to sharing our concerns with the White House, I have met with CMS and members of Congress to encourage them to take action. Congress listened and introduced the Medicare Advantage Participant Bill of Rights Act of 2014 that would enhance patient and physician protections, and improve transparency in the Medicare Advantage networks. CMS is concerned with this issue, but needs to hear from our patients. We must make sure that our patients’ voices are heard so they can get the care they need.

We also need to do our own data collection to show the insurers and government that we provide high quality, cost-effective care. Data registries cost a lot of money so I am calling for you to support a very modest $50 dues increase to pay for this key initiative in addition to a cost of living increase to sustain our organization down the road. We have not had a dues increase in 13 years and inflation has eaten up 30 percent of our budget.

The time is ripe for our specialty to work hand-in-hand with other organizations, government agencies, and patients to make a positive dent in this public health initiative. It will be up to us to make sure that we are collaborating at all levels and that all groups — including the insurance companies — are on board.