Facing the challenge of health care reform

From the President

Dirk Elston

Dr. Elston served as the Academy's president from March 5, 2013 until March 25, 2014.

Bookmark and Share

The Academy didn’t support its passage, and Americans are deeply divided over many of the elements of its implementation. But after a Supreme Court decision affirming its constitutionality and an election won by its chief proponent, the Affordable Care Act is, for the forseeable future, the law of the land. This leaves dermatologists with an important challenge: How do we ensure the future of our specialty, and the optimal care of our patients, in a rapidly changing health care landscape?

There may be opportunities to influence specific provisions of the law; for instance, we continue to support legislation to repeal the Independent Payment Advisory Board, or IPAB, an unelected 15-member panel who would be empowered to make decisions about Medicare spending cuts with very limited oversight or recourse. With support for this repeal on both sides of the aisle, we have real hope for progress on this front.

The Academy cannot sit idly by. We have to be actively engaged so that we can exert a positive influence on regulations that will affect the care of our patients. We need to embark on scenario planning, so that we are ready for any changes that may come our way. We start by putting some of the brightest minds in the field on the problem. At the end of this month, dozens of dermatologists will gather in Washington, D.C., for the American Academy of Dermatology Association’s health policy strategic retreat. Invited participants include members of the Board of Directors; the Council on Government Affairs, Health Policy, and Practice; the Dermatology Section Council to the AMA House of Delegates; and members of key committees and task forces involved in health policy, including the Access to Dermatologic Care Committee, Congressional Policy Committee, Health Care Finance Committee, Private Sector Advocacy Task Force, and Workforce Task Force. [pagebreak]

These participants will consider the strategic direction the Academy will take in response to anticipated changes in the health care environment. They will discuss the ACA’s impact on that environment, including how new models of delivery and payment are being adopted and how the physician community has begun to respond, both collectively and individually, to these changes. They will review the Academy’s actions to date. And they will examine concrete actions the Academy must take to ensure the future of our specialty, help empower dermatologists in practice, and preserve access to the best dermatologic care available.

I call on each of you to examine where you fit into this puzzle, what you can contribute, and what you need to change. What is at stake is quite simply: How does dermatology retain its place among medical specialties and ensure that our efforts lead to the best possible treatment for patients with skin disease? For each of you, there will be similar questions: What do I need to do to ensure that I continue to provide optimal care to my patients in a changing world? What can I do to help the Academy ensure the future of our specialty? There is much that each individual can contribute, and the Academy’s new grassroots advocacy network provides many opportunities to be involved.

We are all in this together, and with the Academy, state, and local societies working in concert with our subspecialty societies, we can ensure a coordinated response. The Academy will help you to anticipate change, remaining a step ahead and prepared for whatever comes, and provide you with the information you need to make informed choices. In the meantime, I encourage you to affect change by becoming a part of our expanding state-based grassroots advocacy leaders. Forming a responsive peer-to-peer network amongst our colleagues, the Grassroots Advocacy Workgroup has put together a series or programs to engage and activate membership participation in the public policy making process. For more information please email Blake McDonald, AADA staff, at grassroots@aad.org