The times they are a-changin'
From the President
Dr. Hruza served as Academy president from March 2019 to March 2020.
By George Hruza, MD, MBA, September 2, 2019
Who knew more than 50 years ago, that this iconic Bob Dylan song could apply to health care? The U.S. health care system has weathered some significant shifts since the 1960s. Shortly after this song hit the radio waves, Congress enacted, and President Johnson signed, a little program called Medicare (ever heard of it?) under the Social Security Act. On a more subtle scale, medicine has seen the evolution of medical devices and medications over the years — sometimes for the better; sometimes for naught. I often wonder what the debate behind these changes entailed among our colleagues of the day. Inevitably, health care and medicine evolve with time, and with those changes comes great debate.
Fast forward to present day, we are seeing a shift in dermatology practice settings. While AAD survey data indicate that dermatologists have maintained both primary ownership and management of their practices, a notable 14% of dermatology practices are now owned by a private equity-backed entity. Integrated health care systems, academic medical centers, multispecialty groups, and even insurance companies are getting into the act with a majority of physicians now employed. Some of our colleagues argue that the consolidation of dermatology practices can improve efficiency, strengthen leverage with large insurers, and allow the physician to step away from the administrative tasks and financial challenges associated with running a practice. Our other colleagues are concerned that the future of the specialty lies in the hands of a corporate or other non-physician-run entity, leaving the physician with less autonomy over patient care.
No matter where you fall on the opinion spectrum regarding this issue, the Academy is making sure that you have all the information available to you as you decide what’s best for you and your practice. Visit the AADA’s Practice Management Center and check out the resources and guidance that Academy staff has developed for you about various practice settings.
Another health care change that we’ve seen evolve in recent history is the role of the non-physician clinicians in health care. We are all stretched incredibly thin, with increasing patient loads and growing piles of administrative work. As a result, many physicians have employed non-physician clinicians to assist them. Again, this issue has prompted spirited debate within our specialty.
As such, your Academy supports the board-certified dermatologists who lead care teams and recognizes that, under the direction of a board-certified dermatologist, the practice of dermatology benefits from a collaborative care team approach. With the trend in medicine toward care teams, your Academy has developed the AAD DermCare Team, which offers AAD member dermatologists the opportunity to enroll their care team members to receive educational opportunities, such as professional development resources and the latest research findings. By enrolling your non-physician clinicians in the DermCare Team, we help ensure the provision of high-quality patient care.
No matter who you are, change can cause great apprehension and angst. However, anyone who has spent even just a few years in health care knows that change is inevitable. I would also argue that debate is healthy. Regardless of whether we are of the same mind when it comes to the evolving facets of health care, with our Academy by our side we will navigate these shifts together as a unified specialty.
