Lushniak: Dermatologists can change the world. Joyfully

Service is about expanding what you think you are, what you think you can do, what you think you can accomplish.

Boris Lushniak, MD, MPH

“When you think about yourself, skip the ‘only,’ as in ‘I’m only a surgeon’ or ‘I’m only a dermatologist,’” said Boris Lushniak, MD, MPH, professor and dean of the University of Maryland School of Public Health. “Think about what needs to be done and how you can make it happen. That is the essence of service and leadership. Think about Clarence Livingood.”

Dr. Livingood became a dermatologist in 1936, enlisted in the U.S. Army in 1941, co-authored the Military Manual of Dermatology, and became a teacher, clinician, and researcher. He shaped the specialty of dermatology in the mid-20thcentury and helped create organized medicine, Dr. Lushniak said. Dr. Livingood became the AAD delegate to the AMA, president of the AAD, SID, and the ADA, executive director of the ABD for 30 years, and somehow found time to serve as the team physician for the Detroit Tigers.

“This guy was one of the rock stars of dermatology,” Dr. Lushniak said, “and his entire career was about service — to patients, dermatology, medicine, the world. He wasn’t only a dermatologist, he was a leader.”

Dr. Lushniak received the 2019 Clarence S. Livingood, MD Award and Lectureship during the plenary session on Sunday.

“We have many roles as dermatologists,” Dr. Lushniak said. “We are physicians, experts, researchers, educators, advocates, voters, family, and community members. And most of all, we are leaders. Leadership not only helps others, it can help us deal with burnout.”

Dr. Lushniak noted that the key to fighting burnout is to care for yourself and to recharge your motivation. That means reconnecting with your purpose as a physician, branching out, and fighting for what you believe in. He recommended that dermatologists take advantage of the new Derm360 section of the Academy’s Practice Management Center to address these issues.

Leadership

Dermatologists are leaders almost by definition, he continued.

They are highly capable individuals and contributing members of the health care team. Most become competent managers, organizing people and resources toward the effective and efficient pursuit of a predetermined objective, improving skin health.

Effective leaders have a clear and compelling vision and high performance standards while catalyzing commitment. The best build enduring greatness with a paradoxical blend of personal humility and professional will.

“The main goal of the leader is not to shout ‘look at me,’” Dr. Lushniak said. “The sole goal of a great leader is to serve the organization.”

Dermatologists share the common goal of preventing disease, prolonging life, and promoting health, he continued. As an organization, the AAD has clearly established itself as the leader.

Some 2,000 members provide free skin cancer screenings every year as part of SPOTme Screenings. Since the program began in 1985, they have provided more than 2.7 million free skin cancer screenings with more than 271,000 suspicious lesions detected and more than 30,000 suspected melanomas.

Dermatologists are equally effective as advocates. In 2009, only two states, Texas and Maine, had restrictions on indoor tanning for minors. A decade later, only seven states, Alaska, Colorado, Idaho, Iowa, Montana, New Mexico, and South Dakota, allow unrestricted access.

“The situation is not perfect,” Dr. Lushniak said, “but we have been out there. We have been activists. We have changed the world through our leadership. We have acted, and we must continue to do so.”

More intervention

Advocating for more, and more effective protective interventions such as skin cancer screening and reduced indoor UV exposure is good, he continued, but not enough. The most effective way to improve health is to change the basic socioeconomic factors that contribute to poor health.

The Centers for Diseases Control and Prevention (CDC) has identified poverty, lack of education, housing, and inequality as the factors that have the greatest impact on health status.

“We, as physicians, as a society, as family and community members, as voters, as leaders, we can act, and we change the world,” Dr. Lushniak said. “Leadership is joy.”

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