Dermatology is a taxing specialty
From the Editor
By Warren R. Heymann, MD, FAAD, April 1, 2026
April 15 may be Tax Day, but every day is taxing for dermatologists. This issue of DermWorld focuses on making practice less taxing administratively and clinically.
The financial pressures facing dermatologists are relentless — declining reimbursement, inflation, claim denials or withholding prior authorizations. Compounded by the need to manage your administrative team, they can stress even the most even-keeled among us. Reading our feature article on payer policies will help guide you through the AAD resources to assist you in proper documentation and coding, streamlining prior authorizations and appeals, leveraging data and benchmarking with the DataDerm™ registry, negotiating contracts, and learning how the AAD can serve as your advocate. The Academy’s payer advocacy team and the Patient Access and Payer Relations Committee help build policy leverage. Report your issues to the AAD so that systemic issues can be addressed collectively.
Leadership is essential for effective management, whether in the office or in organized medicine. Quoting the famed Green Bay Packers football coach Vince Lombardi, “Leaders are made, they are not born. They are made by hard effort, which is the price that all of us must pay to achieve any goal that is worthwhile.” The AAD’s Leadership Institute has had a dramatic impact on dermatologists across all clinical venues by providing resources to enhance practice management skills. Since 2002, more than 1,200 dermatologists have participated in the Leadership Forum, with workshops geared toward early-career dermatologists. The Advanced Leadership Forum has involved over 200 AAD members since its inception in 2014. Learn how these forums enhance management skills, provide networking opportunities, and offer mentorship for participants. Consider how mentorship can help you as a mentor or mentee in the Academic Dermatology Leadership Program, the Diversity Mentorship Program, Flash Mentoring Program, and the JAAD Editorial Mentorship Program. Leadership skills must always be honed — for the betterment of our patients, practices, and institutions. Let the AAD be your partner in developing a critical leadership skillset.
In 1948, the brilliant pathologist Dr. Sophie Spitz challenged standard pathology dogma when she stated, “It has become apparent over a period of years that even when a histologic diagnosis of malignant melanoma has been made in children, the clinical behavior rarely has been that of a malignant tumor.” Nearly 80 years later, Spitz nevi remain a source of consternation as we seek to understand their nature and accurately differentiate benign Spitz nevi, atypical Spitz nevi, and Spitz melanoma. If Dr. Spitz were alive today (unfortunately, she died at age 46 of metastatic colon cancer), she would be enthralled to learn of the modern molecular techniques of immunohistochemistry, next-generation sequencing, comparative genomic hybridization, and gene expression profiling that can help unravel the pathogenic mysteries of these lesions, helping to guide our patients to proper care. The article on Spitz nevi will be the first of several articles on what clinical dermatologists should know about molecular techniques in dermatology.
Aside from Tax Day and showers, April brings warmth, baseball, and renewal. This issue of DermWorld should rejuvenate all aspects of your practice in this splendid Easter and Passover season. Happy holidays!
