By Ronald L. Moy, MD, AAD President, October 01, 2011
In the last few years, many of us have turned our attention to the federal government, concerned with how health system reform might affect the practice of dermatology. While it made perfect sense for us to focus on what was happening in Washington, D.C., I know from firsthand experience serving on the Medical Board of California that many of the most important decisions about how medicine is — or isn’t — regulated are made at the state level.
Fortunately, the American Academy of Dermatology Association has member volunteers and a staff who have been unwaveringly focused on ensuring that our specialty’s concerns at the state level are addressed. The Academy has been active on issues including the practice of medicine in spas, the scope of practice of non-physician providers, truth in advertising and appropriate identification of health care professionals, restricting the use of tanning beds, and protecting dermatologists’ ability to offer office-based surgery to our patients. Kathryn Chandra, our assistant director for state policy, travels the country to work with state dermatology societies to testify at hearings related to these issues and coordinates the Academy’s efforts with the work of the American Medical Association and national medical specialty societies. Each of us knows the challenges of keeping up to date with changing laws and regulations in our states. Multiply that by 50 and you have a sense of the scope of effort required for the AADA to track and respond to these issues.
Why is it important to track bills and proposed regulations at the state level? It’s been several years since dermatologists faced challenges to our ability to perform surgery in our offices, but 2011 has seen the emergence of efforts to require mandatory accreditation of any facility where any degree of surgery is performed. One bill in New Jersey would require accreditation of any facility where body contouring with skin excision took place — a definition so vague it could encompass every dermatology practice in the state.[pagebreak]
While our own ability to practice is threatened by legislation like that, non-physician providers seek expansions of their own scope of practice. But we are not merely defending ourselves — we are proactively seeking to protect our patients. We support laws and regulations that require medical providers to appropriately identify themselves in their advertisements and to patients, with nametags and promotional materials that include accurate information about their degrees and credentials, including their board certification. And we support legislation to protect young people from the damaging effects of tanning bed use; this year alone we’ve tracked 46 pieces of legislation in 26 states related to indoor tanning. Many of these bills would advance our cause, but the tanning industry occasionally finds sponsors for bills that would roll back tanning regulation or grant tanning bed operators new authority. In Nebraska, for instance, a bill we testified against would have allowed tanning bed operators to be licensed as phototherapists! Our work to oppose bills like this is vital.
Many of you are already helping out in these state-level efforts. Thank you to Drs. Marc Antezana, Louis Barich, Bruce Brod, Andrea Burch, Craig Burkhart Jr., Gene Burrish, Tami Cassis, Scott Collins, Ken Dawes, John Despain, Annette Dinneen, Craig Elmets, Patricia Farris, Mary Finnegan, Denise Forte-Pathroff, Lawrence Green, Alex Gross, Ann Haas, C. William Hanke, Jennifer Herrmann, Laura Klein, Sasha Kramer, Mary Lupo, Trent Massengale, Robert McCallister, Mark McCune, Jason Neustadter, Chris Obeime, Robert Paull, Chad Prather, Sandra Read, Warren Redmond, Jack Resneck Jr., Kathryn Schwarzenberger, Cindy Smith, Stephen Stone, Paul Storrs, Elizabeth Strow, Sabra Sullivan, Stacey Tull, Saundra Vause, Mark Zalla, Michael Zanolli, and many others who have made important efforts in their states.
If you want to get involved, or get more involved, the Academy has created new resources to help you, with a state advocacy toolkit available at www.aad.org/member-tools-and-benefits/aada-advocacy/state-affairs. The toolkit covers important state level issues including medical spa standards, tanning, cosmetic medical procedure taxes, and truth in advertising. It offers important background information on these topics, as well as fact sheets you can bring with you when you meet with legislators. It also includes media outreach tools, such as sample op-eds and letters to the editor you can use to craft pieces for submission to local newspapers.
As these issues continue to emerge in different states, you can be confident that the Academy will do what it takes to meet each new challenge. Want to help? Join the Dermatology Advocacy Network at www.aad.org/dan.