Dermatologists need to take control of their destinies

Jack Resneck Jr., MD: ‘The world is changing and we will be marginalized if we don't adapt.'

Jack Resneck Jr., MD: ‘The world is changing and we will be marginalized if we don’t adapt.’

The Academy has emphasized how the world of health care is changing, and it is a change that makes dermatologists uneasy. Jack Resneck Jr., MD, understands that apprehension, but also sees an opportunity.

“I want to see us thrive,” Dr. Resneck said when he delivered the Clarence S. Livingood Lectureship at the Sunday Plenary. “We have a lot of control over our destiny, but we have a lot of work to do over the next few years.”

The main driver of change is that the government, private insurers, employers, and patients will continue to push back on health care cost increases. The key to meeting those demands is collecting data to quantify quality and cost improvements, he said.

“Also, the image among our peers will matter more,” said Dr. Resneck, associate professor and vice chair of dermatology at the University of California, San Francisco School of Medicine.

To highlight how costs have skyrocketed in the last 15 years, Dr. Resneck explained that in 1999, the annual cost of health insurance for a family of four cost about half of what a person would make if he or she earned the federal minimum wage. Today, that annual insurance cost is greater than a person would make in one year if he or she earned the federal minimum wage.

“More consumers are paying their own bills for health care, and so consumers are going to be more cost conscious,” he said. “And what have the payers done? Their efforts have varied from the mysterious to the blunt to the absurd.”

The answer to those challenges lies in using data to measure outcomes and reduce costs. So, Dr. Resneck asked the question, “If we are thrown into a world of measurement, what would you like to fix?”

“What is the world we want to see?” he asked. “There are things we can dream up where we will not be sacrificing ourselves, and we can help patients and save money. We must have data to develop measures, assess and improve quality, and demonstrate our value. We can take it on ourselves. If we don’t decide this, others will decide for us.”

Dermatologists also must be aware of how other physicians perceive them. Those perceptions are that few dermatologists accept Medicaid or come to the hospital for inpatient consultations, and that that they are only interested in surgery and aesthetics, and use unsupervised physician assistants for complex consultations, Dr. Resneck said.

“I think there is a way forward and that dermatology is going to get out of the morass, move forward and still be a great specialty to be in for years to come, but we have to do some work,” he said. “We must collect data, measure quality, and demonstrate our value.

“But the world is changing and we will be marginalized if we don’t adapt.”

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