Roger I. Ceilley, M.D. is a dermatologist, dermatologic surgeon practicing in Des Moines Iowa. He is an Assistant Clinical
Professor of Dermatology at the University of Iowa Department of Dermatology (Iowa City). He is also the Fellowship Director
of Mohs' Micrographic Surgery And Cutaneous Oncology in Des Moines. He is Chief of the Dermatology Section of the Iowa Methodist
Medical Center.
Dr. Ceilley received his M.D. degree from University of Iowa College of Medicine, where he also took his dermatology residency training. He subsequently took a preceptorship in chemosurgery at the University of Wisconsin. He is currently board certified in dermatology, dermatophathology and Mohs's micrographic surgery and cutaneous oncology. For further biographical information, see the end of this article.
DR. CEILLEY: As a candidate for the presidency of the American Academy of Dermatology, I am pleased to answer your questions regarding electonic communication and the Academy. Though I am not an expert in these issues, I have a strong interest in the subject, and fortunately have access to research and colleagues to assist me. In our practice we have developed computer programs to maintain surgical cancer databases and to generate operative notes, refeerral letters, and so forth.
With the explosion of information and the rapidly accelerating rate of change in medicine today, the computer has become an essential element in the teaching and practice of dermatology. Medical students and residents are now quite knowledgeable about and comfortable with computers. The American Academy of Dermatology (AAD) has been a leader in providing educational courses, consultations, and computer resources for its members. Much more needs to be done. The AAD should strive to use the latest computer technology in its educational endeavors. Interactive computer programs for home study and for use at AAD meetings should be encouraged.
DR. HUNTLEY: How do you think the Academy should be involved with the Internet?
DR. CEILLEY: I feel the AAD should function on the Internet. An AAD Telecommunications Task Force was created to put the AAD on the World Wide Web. Dr. Walter Larsen is the Chairman of this task force, and AAD participation on the Internet is expected by the 1995 summer meeting. Two services are important:
A. MEMBERSHIP SERVICES
This would include such items as public service announcements, patient information pamphlet-like material, answers to frequently asked questions (FAQ's), physician and dermatologic service referral information, and access to dermatologic patient support groups within the Coalition. Public service information can be of great importance as we try to educate the public that dermatologists are the experts in skin diseases and that we can deliver quality dermatologic care in a cost-effective manner.
DR. HUNTLEY: A colleague of mine who is a Family Practitioner and who is also very active running email lists and a gopher site, said that 'there is currently no compelling reason for physicians to use the Internet.' He felt that the available resources on the Internet were not yet of quality and quantity to effect the education or practice of family medicine. If you have had experience with online resources do you agree with that assessment for dermatologists? Do you advocate the use of the Internet by the members of the Academy?
DR. CEILLEY: I am a very strong advocate for the use of the Internet by the members of the AAD. There appear to be more and more reasons to use the Internet. The World Wide Web is rapidly growing, and new services are appearing daily. The AAD needs to inform its members about the many services available (Jerome Litt's Drug Reaction database, etc., Patient Support Groups Lists, dermatologic databases, patient information pages, patient information on melanoma and other skin cancers, teaching materials, scientific manuscripts and abstracts, research information from the GenBank, the NIH and CDC, etc.). Of course, more is needed. It is coming, and some of it will come via the AAD. The AAD should also provide educational programs to teach its members how to best utilize these resources.
DR. HUNTLEY: The Academy seems to spend a lot of effort in various committee meetings. Do you think that some of this activity might be shifted to virtual meetings (resulting in a savings of time and money)?
DR. CEILLEY: The AAD should use computer technology to save time and money whenever possible. The AAD already uses FAX communications and conference call technology extensively. It should and will use other forms of teleconferencing when available and practical. I believe the officers and major committee members should be provided with or have access to laptop computers, so the information now printed and distributed on voluminous notebooks can be accessed via computer disks. Significant savings in mailing and shipping costs could be enjoyed by the AAD. The idea of virtual meetings is intriguing, and should be investigated.
DR. HUNTLEY: Watching the newsgroups today, one finds a smattering of questions and answers which relate to skin diseases. Most of the answers seem to be provided by specialists in other fields or by generalists. Do you think that the Academy should consider sponsoring a NewsGroup or gopher to provide a better source of information to the lay public?
DR CEILLEY: I believe the AAD should continue to be the authoritative and most respected source of reliable public information on skin diseases. An AAD gopher and World Wide Web page for FAQ's would be an excellent idea. Responding to individual questions would perhaps be considered a practice of medicine. The AAD could provide a listing of dermatologists in the area, spokespersons, and other sources for dermatologic care.
DR. HUNTLEY: In regard to the same news-watch, one notes occasionally dermatologists who answer questions, and perhaps it is my bias, but it seems like some of them have a special procedure or product to "sell". Do you think the Academy should provide any guidelines for posting advice on the Net?
DR. CEILLEY: The AAD should develop a position statement for posting advice, distribute it to members, and post it on the World Wide Web page. The AAD can provide leadership in this area, but will find it difficult if not impossible to enforce any ethical positions on the use of the Internet. Guidelines for the use of "telemedicine" will need to be developed.
DR. HUNTLEY: Several years ago Al Kopf and Fred Leavitt created an excellent treatment database,Derm/Rx (now nicely maintained by Van Stoecker). It was way ahead of its time in terms of concept and ability of the membership to access. Since this type of information can be of great use to the practitioner and Internet connections seem to be more common among the membership, do you think the database should be opened to Internet access, and if so should that be at no cost to members?
DR. CEILLEY: A number of very useful dermatologic databases are now available. These include DermRx, DermDDx, Melanoma Prognosis Model, CPT Coding, DermInfoDisc (with full text and images of JAAD), and other electronic products. Whenever possible, the AAD should improve member access to these resources. At the present time, the AAD/DSI revenue from these products are an important source of revenue for the AAD. Some of these services may require fees to be financially viable. Perhaps limited access to these services by the AAD members should be a privilege of membership. The AAD should investigate other sources of funding for these services, such as advertising revenues and educational grants. DR. HUNTLEY: Any thoughts you want to add about dermatology and the information age?
DR. CEILLEY: The AAD has long been a leader in medical education. This is our goal, our mission, our pourpose. The AAD should be a leader in developing Internet potential for serving dermatologists, their patients, the medical community, and the general public. It is our professional obligation.
Dr. Ceilley has served as a Board Member (1981-1984), Secretary (1983-1985), Vice President (1986), President Elect (1987), and President (1988) of the American Society for Dermatologic Surgery. He is also a member of the Iowa Dermatologic Society, where he has served as Secretary Treasurer (1977-1979), President (1980-1981), Delegate to Midwest Congress of Dermatological Societies (1989-1993), and Delegate to Iowa Medicare Advisory Committee (1993- present).
Other dermatologic societies and activities include membership in the Dermatology Foundation, American Dermatological Association, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Society of Dermatopathology, Noah Worcester Society (Board of Directors 1986-1989), American Society for Mohs Surgery, Pacific Dermatology Association (Honorary), and the Society for Pediatric Dermatology. He is a reviewer for JAAD (1988-present), Archives of Dermatology, and The Journal of Dermatologic Surgery and Oncology. His is also a member of the American Medical Association, Alpha Omega Alpha, Iowa Medical Society, Johnson County Medical Society, American College of Physicians, and the Polk County Medical Society. He is a fellow of the American Academy of facial and Plastic Reconstructive Surgery. Since 1990, Dr. Ceilley has served on Senator Tom Harkin's Health Care Advisory Panel.
All contents copyright (C), 1995.
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