Dermatology World July 2011 : Page 1

in this issue from the editor DeAr reADers, We often wax nostalgic about the good ol’ days. ut when it came to sun exposure that mostly translated into many of us getting sunburned. That was often the price of the much sought-after, glorious tan. We are now much smarter when it comes to sun exposure and the inherent risks of skin cancer. Both in the media and on a national level our messages have begun to pay off. Even when the public is not using sunscreens, the need to protect the skin has become household dogma. The Academy’s efforts to educate the public recently hit new heights as the FDA defined new labeling requirements for sunscreens for both UVA and UVB protection that largely reflected our input. Highlighting the FDA’s appreciation of derma-tology’s input, both Ronald Moy, M.D., and Henry Lim, M.D., were invited to participate in this announcement. Pretty nice for dermatology if I do say so. Understanding sunscreen products and how fully they can protect the skin will hopefully allow the public to be smarter users. It might even encourage some manufacturers to remove their less effective products from the market. Certainly we’ve taken our hits — there have been challenges to the value of sunscreens, or more specifically sun exposure, by those concerned about vitamin D levels. What is quite clear, though, is that the days of baby oil and reflectors are over. Maybe we’ll be able to keep some of the public from becoming our future patients. This month’s features are very important ones for you to read. The piece on ACOs — accountable care organizations, if you’re not up on the jargon — is one not to miss. While we might wish that these organizations will not materialize, ACOs have the potential to change the ground rules of practice fun-damentally. Therefore, dermatologists need to be up to speed on what is being discussed. How we as dermatologists will want or need to participate in these organizations remains uncertain. Rest assured, given these uncertainties, Dermatology World will be helping us stay abreast of this topic. Social media started as something my kids did for kicks, but boy, has this exploded into a full force in its own right. I think that you’ll find that this month’s article on social media has lots for everyone. While only half of us are currently participating, this is an important upcoming tool. It has wonderful potential, ranging from advertising one’s practice, to hiring employees, as well as interfacing with other physicians both socially and professionally. But there are some pitfalls as well. Trying to manage these potential downsides is equally important. None of us wants to find our practices being discussed in a negative light and not know what to do next or have staff who can’t seem to stay off Facebook long enough to help us with our patient care. So be sure to read and let us know what you think — how do you see this fitting in to your practices day-to-day? Our Acta Eruditorum column this month on the potential pitfalls of teledermatology is another must-read. Daniel Federman, M.D., raises some important concerns about the limita-tions of this tool when used in the real-world setting in his recent Archives article. As we begin to embrace technology to serve communities with limited access to dermatology both in the U.S. and abroad, we need to be cognizant of the limitations. It’s up to us to understand where it can fail, and champion strategies to try to circumvent these possible problems. Each month the choice of what I want to highlight for you is such a challenge, so please don’t limit yourself to just these few. Dirk Elston’s column on multiple procedure codes is really a good one. I think you’ll like that we’ve moved into more challenging situations in our coding advice. And we all will benefit from reading Alexa Kimball’s wisdom about balancing it all. Hopefully we’ll all get some R and R in these next weeks, giving you time to read this issue cover to cover. And of course, when you do, be sure to bring your sunscreen. As always feel free to email me at dweditor@aad.org with questions and comments or simply your summer vacation plans. Enjoy your reading. B Vol. 21 no. 7 | JULY 2011 PResident contRibuting wRiteRs Ronald L. Moy, M.D. Physician ReVieweR Suzanne Olbricht, M.D. Physician editoR Abby Van Voorhees, M.D. executiVe diRectoR & ceo Ronald A. Henrichs, CAE dePuty executiVe diRectoRs Karen Collishaw, CAE Eileen Murray, CAE PublisheR Coura Badiane Jan Bowers Ruth Carol Rachna Chaudhari Cyndi Del Boccio Dirk Elston, M.D. Shannon Gignac Nikki Haton Kara Jilek Alexa Kimball, M.D., M.P.H. Allen McMillen Scott Weinberg editoRial adVisoRs Lara Lowery editoR Katie Domanowski Managing editoR Richard Nelson staff wRiteR John Carruthers design ManageR Ed Wantuch editoRial designeR Theresa Oloier Lakshi Aldredge, MSN, ANP-BC Tina Alster, M.D. Rosalie Elenitsas, M.D. John Harris, M.D., Ph.D. Chad Hivnor, M.D. Sylvia Hsu, M.D. Risa Jampel, M.D. Christopher Miller, M.D. Christen Mowad, M.D. Philip Orbuch, M.D. Wendy Roberts, M.D. Robert Sidbury, M.D. Printed in U.S.A. Copyright © 2011 by the American Academy of Dermatology Association 930 E. Woodfield Rd. Schaumburg, IL 60173-4729 Phone: (847) 330-0230 Fax: (847) 330-0050 Mission stateMent: Dermatology World is published monthly by the American Academy of Dermatology Association. Through insightful analysis of the trends that affect them, it provides members with a trusted, inside source for balanced news and information about managing their practice, understanding legislative and regulatory issues, and incorporating clinical and research developments into patient care. Dermatology World® (ISSN 10602445) is published monthly by the American Academy of Dermatology and AAD Association, 930 E. Woodfield Rd., Schaumburg, IL 60173-4729. Subscription price $48.00 per year included in AAD membership dues. Non-member annual subscription price $108.00 US or $120.00 international. Periodicals Postage Paid at Schaumburg, IL and additional mailing offices. PostMasteR: Send address changes to Dermatology World ®, American Academy of Dermatology Association, P.O. Box 4014, Schaumburg, IL 60168-4014. ABBy S. VAN VOORhEES, M.D., PhySICIAN EDITOR Dermatology WorlD // July 2011 1

From The Editor

Dear readers,<br /> <br /> We often wax nostalgic about the good ol’ days.<br /> <br /> But when it came to sun exposure that mostly translated into many of us getting sunburned. That was often the price of the much sought-after, glorious tan. We are now much smarter when it comes to sun exposure and the inherent risks of skin cancer. Both in the media and on a national level our messages have begun to pay off. Even when the public is not using sunscreens, the need to protect the skin has become household dogma.<br /> <br /> The Academy’s efforts to educate the public recently hit new heights as the FDA defined new labeling requirements for sunscreens for both UVA and UVB protection that largely reflected our input. Highlighting the FDA’s appreciation of dermatology’s input, both Ronald Moy, M.D., and Henry Lim, M.D., were invited to participate in this announcement. Pretty nice for dermatology if I do say so.<br /> <br /> Understanding sunscreen products and how fully they can protect the skin will hopefully allow the public to be smarter users. It might even encourage some manufacturers to remove their less effective products from the market. Certainly we’ve taken our hits — there have been challenges to the value of sunscreens, or more specifically sun exposure, by those concerned about vitamin D levels. What is quite clear, though, is that the days of baby oil and reflectors are over. Maybe we’ll be able to keep some of the public from becoming our future patients.<br /> <br /> This month’s features are very important ones for you to read. The piece on ACOs — accountable care organizations, if you’re not up on the jargon — is one not to miss. While we might wish that these organizations will not materialize, ACOs have the potential to change the ground rules of practice fundamentally. Therefore, dermatologists need to be up to speed on what is being discussed. How we as dermatologists will want or need to participate in these organizations remains uncertain. Rest assured, given these uncertainties, Dermatology World will be helping us stay abreast of this topic.<br /> <br /> Social media started as something my kids did for kicks, but boy, has this exploded into a full force in its own right. I think that you’ll find that this month’s article on social media has lots for everyone. While only half of us are currently participating, this is an important upcoming tool. It has wonderful potential, ranging from advertising one’s practice, to hiring employees, as well as interfacing with other physicians both socially and professionally. But there are some pitfalls as well. Trying to manage these potential downsides is equally important. None of us wants to find our practices being discussed in a negative light and not know what to do next or have staff who can’t seem to stay off Facebook long enough to help us with our patient care. So be sure to read and let us know what you think — how do you see this fitting in to your practices day-to-day?<br /> <br /> Our Acta Eruditorum column this month on the potential pitfalls of teledermatology is another must-read. Daniel Federman, M.D., raises some important concerns about the limitations of this tool when used in the real-world setting in his recent Archives article. As we begin to embrace technology to serve communities with limited access to dermatology both in the U.S. and abroad, we need to be cognizant of the limitations. It’s up to us to understand where it can fail, and champion strategies to try to circumvent these possible problems.<br /> <br /> Each month the choice of what I want to highlight for you is such a challenge, so please don’t limit yourself to just these few. Dirk Elston’s column on multiple procedure codes is really a good one. I think you’ll like that we’ve moved into more challenging situations in our coding advice. And we all will benefit from reading Alexa Kimball’s wisdom about balancing it all. Hopefully we’ll all get some R and R in these next weeks, giving you time to read this issue cover to cover. And of course, when you do, be sure to bring your sunscreen. As always feel free to email me at dweditor@aad.org with questions and comments or simply your summer vacation plans.<br /> <br /> Enjoy your reading.<br /> <br /> ABBY S. VAN VOORHEES, M.D., PHYSICIAN EDITOR

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