What does the future of our specialty look like?

From the President

Ronald L. Moy

Dr. Moy was Academy president from Feb. 8, 2011 until March 20, 2012.

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Presidents of the American Academy of Dermatology have many experiences that can give us a perspective into our specialty’s future. I have traveled more than any president as we have expanded our interactions with industry and our international colleagues. I have met the CEOs of almost all of the major companies that do business with dermatologists and with the Speaker of the House; I have given press conferences with the FDA and members of Congress. I have signed almost every correspondence that has gone out on the AAD letterhead, and learned about all the great work that goes on between our volunteer members and the AAD staff. I have also learned about problems and issues within our organization. I have worked with the Board of Directors who are collectively wise. I have met or talked with the presidents of the European Academy of Dermatology and Venereology, the Chinese Dermatologic Society, many of the other dermatologic societies, and the American Society of Plastic Surgeons.

Prior to being president, I served on the Medical Board of California for seven years, and I was the editor-in-chief of Dermatologic Surgery, co-chief of the UCLA division of dermatology, and a principal investigator of NIH and VA research grants. I served on our ACGME Residency Review Committee for Dermatology and as president of the American Society for Dermatologic Surgery.[pagebreak]

Most importantly, I have talked or emailed with many AAD members. From all of these experiences, I have some predictions about our specialty’s future:

  • 1. There will be fewer dermatologists because Medicare funding for Graduate Medical Education will be drastically cut due to efforts to reduce the national deficit. The AADA has been and will be opposing these potential reductions, of course. But the pressures to find places to save will be great. Fewer dermatologists will mean longer wait times to see physicians with such expertise. Academic departments may become smaller.
  • 2. Dermatologists will continue to be innovtive in adopting new technologies to improve patient care and outcomes as well as increase efficiencies within their practices. Whether it’s a new treatment or a new EHR, our specialty will benefit from early adopters who will influence and refine the products to make them better.
  • 3. The strong likelihood of declining reimbursement from public and private insurance entities may compel more physicians to operate concierge practices, drop insurance altogether, increase the proportion of self-pay and/or cosmetic patients they see, or become employed by a larger group or system.
  • 4. The demand for dermatology services coupled with the shrinking physician workforce and policies to incentivize the use of lower level providers will mean that more physician extenders and other physicians will increase their share of the market. Dermatologists will continue to disagree over who or what entity is most appropriate to educate these growing numbers of providers and what their appropriate place is within the dermatologic care team.
  • 5. The imperative to coordinate and integrate the care of the patient with other providers will intensify. 
  • 6. Following in the footsteps of the banking and aviation industries, the medical community will be transformed by the use of health information technology to standardize what can be standardized and learn from the data that is available. The Academy will continue to help members navigate these changes through tools like our online HIT-Kit, available at www.aad.org/hitkit.
  • 7. Continuing professional development will be designed to translate evidence into practice, and there will be an expectation that it will provide measurable change in competence and performance with the goal of improving patient care outcomes.
  • 8. Learning opportunities will employ a diversity of delivery methods and technologies, and accommodate different learning preferences.
  • 9. New molecular treatments that target skin diseases and are designed for individual patients will become available and change the way we treat many conditions.
  • 10. We will see more confusion from the public over the expert role of a dermatologist, necessitating continued and evolving communication efforts on the part of your Academy to ensure that our expertise in the skin, hair, and nails is known by patients who need us.
  • 11. Continued scrutiny of industry relationships to medicine will affecting funding for continuing medical education, clinical research, and drug and treatment development.
Our specialty will continue to do well if we innovate well, advocate to our government well, educate our members well, communicate to the public well, and prepare for future changes. Yogi Berra said, “It’s tough to make predictions, especially about the future.”