Changing health care landscape: Dermatology’s future looks bright

By Brett Coldiron, MD, and Marta Van Beek, MD, MPH

"The future of dermatology is brighter than many other specialties, but you will need vigilance to make it happen." This was the assessment offered by Jack Lewin, MD, one of the presenters at the AADA Health Policy Strategic Retreat last month.

The retreat offered AADA leaders the opportunity to contemplate the future and consider just what type of vigilance will be required to assure a bright outcome for the specialty. In addition to Dr. Lewin, who is principal of Lewin and Associates – Health Innovation Strategies,  Jack Resneck, MD, past chair of the AADA Council on Government Affairs, Policy, and Practice, and Kevin Fiskensher, MD, CEO of the American Medical Informatics Association, offered thoughts and insights that helped set the stage for a robust and productive discussion.

During the event, participants, who represented a cross section of the specialty, discussed various possible scenarios and their implications for dermatology. These included a future where primary care is the backbone of the health care system, coordinating care and providing basic medical dermatology care to patients. Another scenario considered a world in which ACOs dominate health care and dermatologists have embraced team care models. Our third scenario contemplated a payment system based on quality and outcomes rather than the current fee-for-service model.

Our task was to consider the implications of each of these for the specialty and come up with areas of focus critical for the future success of the specialty. Over the course of two days and through a variety of collaborative exercises we arrived at the following six areas:

  • Guidelines, metrics, and outcomes: Defining and demonstrating value by creating a set of quality metrics that facilitate meaningful outcomes research.
  • Team care business models: Developing best practices in dermatology care coordination.
  • Purchasers: Making the case for the value of dermatology.
  • Telemedicine: Advancing appropriate triage and teledermatology.
  • Primary care: Collaborating to develop mutually beneficial relationships.
  • Patients: Understanding their experience, increasing satisfaction, and improving adherence to treatment.

We discussed a variety of tactics to advance the specialty in these areas, including new and expanded programs. The Board of Directors will consider these recommendations and necessary resources associated with them this fall.

Change is always unsettling, and this exercise in examining not just our strengths — of which we have many — but also our vulnerabilities and weaknesses was sometimes difficult. In his talk, Dr. Fickensher called on physicians to step up to the challenges of solving health care’s problems. This retreat was dermatology stepping up.

We are proud of the effort made and commitment shown by all the participants. AADA members can rest assured that your leadership is committed to working for that bright future for dermatology.

Brett Coldiron, MD, and Marta Van Beek, MD, MPH, co-chaired the planning team that organized the Health Policy Strategic Retreat, May 31 – June 1 in Washington, D.C. Dr. Van Beek is the chair of the AADA Council on Government Affairs, Health Policy, and Practice. Dr. Coldiron is the AADA president-elect.

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