President's Message: Upcoming vote — additional information
Oct. 20, 2019
Later today you will receive an email with a code and a link so you can vote on whether to remove Scott M. Dinehart, MD, FAAD, from the American Academy of Dermatology/Association (AAD/A) Board of Directors.
The Academy has received various requests for clarification of the events surrounding the call for this removal vote and I am taking this opportunity to review the sequence of events that led to this point and clarify several misimpressions raised by some members regarding his involvement with the American Board of Dermatology Physician Assistants, LLC (ABDPA).
After the launch of the ABDPA was announced on BusinessWire on October 7, 2019, the Board carefully investigated the matter to determine Dr. Dinehart’s involvement and its potential conflict with his responsibilities as a fiduciary with respect to duty of care, loyalty, obedience and liability risk. Following are the Board’s findings:
Dr. Dinehart was the sole incorporator and organizer of the for-profit entity, American Board of Dermatology Physician Assistants, LLC. He registered its internet domain name in February of 2018, trademarked the ABDPA in June of 2019, and incorporated the ABDPA in the State of Arkansas in September of 2019. The ABDPA offices of record correspond with his medical practice and his home. A majority of the ABDPA Executive Board is controlled by Dr. Dinehart and his employees.
The mission of the ABDPA is in direct conflict with the AAD/A Position Statement on Truth in Advertising and Professional Disclosure that states that practitioners should not advertise that they are board certified unless they are certified by an ABMS/AOA medical board, such as the American Board of Dermatology. By forming and organizing a certifying body for physician assistants and calling it the American Board of Dermatology Physician Assistants, Dr. Dinehart was directly enabling physician assistants to advertise themselves as board certified in direct conflict with the AADA’s longstanding policy. Dr. Dinehart is quoted in the Northwest Arkansas Democrat Gazette on October 8, 2019 as such:
Patients want information on their health-care providers, whether they’re physicians or physician’s assistants, he said, and certification often serves as a signal of competency. “I think people have a little more confidence in someone who is Board Certified,” Dinehart said. “You know they’ve been through a course of study, you know they’ve taken a test in their field.”
The misleading name of the ABDPA has created widespread confusion within the dermatology community among both physicians and physician assistants. The ABDPA has been denounced by the American Board of Dermatology and the Society of Dermatology Physician Assistants. The ABDPA also is independent of the National Commission on Certification of Physician Assistants, which is the certifying organization for PAs.
Based on these findings, the AAD/A Leadership contacted Dr. Dinehart on October 9 to describe their concerns about the irreconcilable conflict of interest and outlined the logistical options for Dr. Dinehart. Those options included voluntarily resigning or proceeding with an AAD/A Board discussion and vote to initiate the removal process.
Dr. Dinehart did not disclose to the AAD/A his past involvement with the ABDPA until October 13, 2019 after being presented with the prospect of a removal vote as required by the Academy’s Administrative Regulation (AR) on Disclosure of Outside Interests and Management of Conflicts of Interest.
Although the ABDPA website has been shuttered, Dr. Dinehart’s organization and public promotion of the ABDPA in violation of his fiduciary duties has harmed the AAD/A and its members.
This removal vote was initiated by a unanimous, closed vote of the AAD/A Board after reviewing the above evidence with Dr. Dinehart, allowing him to make a statement, and providing an opportunity to answer all questions from the Board. Board members’ votes were by secret ballot to allow members to vote their conscience. In addition, the general election removal vote is being held at the request of concerned Academy members who submitted a duly qualified petition seeking Dr. Dinehart’s removal. Pursuant to the Minnesota Non-Profit Corporation Act, the AAD/A Bylaws and the Administration Regulations (AR) for the removal of Officers or Directors, either a Board action or a member petition trigger a removal vote. In the case of Dr. Dinehart, both the Board action and the member petition threshold have been achieved.
The AAD/A leadership has tried to limit the controversy and discomfort of this situation by affording Dr. Dinehart three separate opportunities to resign: 1) prior to the Board meeting (October 9-14); 2) after the Board decision but before publicly announcing the vote (evening of October 14); and, 3) then again over this weekend. He declined, each time.
Finally, I want to re-affirm that removal of Dr. Dinehart will be predicated on a two-thirds vote of at least 10% of the members eligible to vote in the election of directors. This is the requirement as outlined by the Minnesota Non-Profit Corporation Act, the Bylaws, the AR for Removal of Officers or Directors, the AR for Interpretation of the Academy’s and Association’s Bylaws and Administrative Regulations, and the American Institute of Parliamentarians, Standard Code of Parliamentary Procedures — AAD/A’s parliamentary procedure as stipulated in the AAD/A Bylaws. Our process has been carefully evaluated and guided by AAD/A legal counsel.
I regret that we have been put in this difficult position and that the question must be put to the membership for a painful vote. The Academy has a lot of important work to do to advocate for our members and our patients. This issue has been an unfortunate distraction from that important work. Thank you for your consideration of this important matter.
George J. Hruza, MD, FAAD
President, American Academy of Dermatology/Association