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News from the American Academy of Dermatology
Thomas L. Ray M.D.
Dermatology Online Journal Volume 2: Number 1: 13


Dermatology News from the AAD (and elsewhere!)
Gene Linked to Basal Cell Ca Lawley - Interim Dean New Online Services
Candidates for AAD Offices New HCFA Fee Schedules Proposed AAD Survey Results

Gene Linked to Basal Cell Carcinoma and the Basal Cell Nevus Syndrome ! !

Science, June 14, 1996 Issue. Volume 272:1668-1671. Abstract. Teams of scientists and dermatologists at Stanford University and the University of California at San Francisco describe a candidate gene that may be the genetic basis for the developmental anomalies and progressive appearance of basal cell skin cancers in the basal cell nevus syndrome, as well as acquired basal cell carcinomas. The gene - called patched (ptc) - is well characterized in Drosophila (fruit flies) and encodes a transmembrane protein critical for signaling proteins that control the development of numerous tissues. The significance of this work is summarized in the News section article of Science Genetics: Gene Linked to Commonest Cancer.

Appointments

Another dermatologist assumes the responsibilities of a Dean at a major medical school.
Thomas J. Lawley, M.D., has been appointed the Interim Dean at Emory University and Vice Chair of the Emory University System of Health Care, succeeding Jeffrey L. Houpt, M.D., who will remain on the faculty, while on a year sabbatical. Dr. Lawley previously served as Executive Associate Dean and Chair of Dermatology at Emory. Dr. Lawley joins the ranks of other dermatologists holding deanship responsibilities at major institutions - Dr. Gerald Lazarus, Dean at the University of California at Davis, and Dr. Lowell Goldsmith, Dean at the University of Rochester.


AAD Offers New Online Services

The American Academy of Dermatology launched a new business service for Academy members wanting to establish a presence on the World Wide Web. NetOn-Line Services (N.O.L.), a joint venture of the AAD and its subsidiary Dermatology Services Inc. (DSI), provides multiple Internet and WWW services, including design and implementation of business Websites for members, e-mail services, and bulletin board services. All aspects to building a presence on the Internet and the World Wide Web can be provided through the NetOn-Line Services. Additional information is available through the the following sources:

Telephone: 847 - 330 - 9830
FAX: 847 - 330 - 0050
E-Mail: mcavanaugh@aad.org
WWW: http://www.neton-line.com

Candidates for AAD Offices and Board of Directors Named

The Nominating Committee of the AAD recently named the following candidates for:

President-Elect:

  • Dr. Lynn A. Drake - Boston, Massachusetts
    • Current AAD Committee duties:
      • Section on Education, Evaluation and Scientific Assembly
      • Scientific Assembly
  • Dr. Irwin M. Freedberg - New York, New York
    • Current AAD Committee duties:
      • Futures Committee

Vice President-Elect

  • Dr. Patricia G. Engasser - Redwood City, California
    • Current AAD Committee duties:
      • Futures Committee
      • Manpower Committee
      • Public Communications Committee
      • Contact Dermatitis Committee

  • Dr. Richard K. Scher - New York, New York
    • Current AAD Committee duties:
      • Dialogues in Dermatology
      • Quality of Care Committee

Board of Directors:

  • Dr. Robert S. W. Basler - Lincoln, Nebraska
    • Current AAD Committee duties:
      • Advisory Board Executive Committee
      • Dermatology Nurses' Association Liaison Task Force

  • Dr. Madeline Duvic - Houston, Texas
    • Current AAD Committee duties:
      • JAAD - Associate Editor
      • Guidelines Task Force: Cutaneous T-Cell Lymphoma
      • Research Council
      • NIA Liaison

  • Dr. Robert Katz - Rockville, Maryland
    • Current AAD Committee Duties:
      • Recertification Education Committee
      • Dermatology Nurses' Association Liaison Task Force

  • Dr. Clifford Lober - Kissimmee, Florida
    • Current AAD Committee Duties:
      • Interdiscipinary Education Committee
      • Section: Health Policy / Practice / Research
      • Health Policy Council
      • Cost Effective Task Force

  • Dr. Mary E. Maloney - Hershey, Pennsylvannia
    • Current AAD Committee duties:
      • JAAD - Associate Editor
      • Section on Education, Evaluation and Scientific Assembly
      • Scientific Assembly Council
      • Academy '96 Committee
      • Education Council
      • Pamphlets Task Force

  • Dr. David M. Pariser - Norfolk, Virginia
    • Current AAD Committee duties:
      • Organizational Structure Committee
      • Advisory Board Executive Committee
      • Interdisciplinary Education Committee
      • Health Policy Council
      • Guidelines / Outcomes Committee
      • Managed Care Committee

  • Dr. Stephen P. Stone - Springfield, Illinois
    • Current AAD Committee duties:
      • Member Services Committee
      • Education Council
      • Dialogues in Dermatology
      • Quality of Care Committee

  • Dr. B. Dale Wilson - Hamburg, New York
    • Current AAD Committee duties:

HCFA Proposes Revisions in Medicare Physician Fee Schedules

The Health Care Financing Administration (HCFA) proposed several revisions in the Medicare Physician Fee Schedule, as published in the

May 3, 1996 Federal Register. Review of the work relative value units (RVU) under the physician fee schedule is mandated at least every five years. The proposed changes affect several dermatology evaluation and management (E & M) codes (increases) and some 17000 and 17100 destruction codes as well as the 10040 acne surgery code (decreases). Comments on the changes will be accepted for 60 days, starting from May 3, 1996. Although the overall impact on all physicianspecialties is neutral, the specialty of dermatology may realize the greatest negative impact, as summarized in the following table from the Federal Register Notice:
   Table 4.--Five-Year Review Impact on Medicare Payments by Specialty  
------------------------------------------------------------------------
                                                               Impact of
                                                                work RVU
                          Specialty                              change 
                                                               (percent)
------------------------------------------------------------------------
Family Practice..............................................        4.6
Internal Medicine............................................        4.2
Hematology Oncology..........................................        3.9
Emergency Medicine...........................................        3.7
Pulmonary....................................................        3.6
General Practice.............................................        3.5
Rheumatology.................................................        3.4
All Other Physicians.........................................        2.9
Neurology....................................................        2.6
Obstetrics/Gynecology........................................        2.0
Clinics......................................................        1.2
Cardiology...................................................        1.1
Otolaryngology...............................................        0.9
Vascular Surgery.............................................        0.5
Gastroenterology.............................................        0.2
Neurosurgery.................................................        0.2
Nephrology...................................................       -0.4
General Surgery..............................................       -0.8
Orthopedic Surgery...........................................       -1.5
Suppliers....................................................       -1.6
Urology......................................................       -1.6
Oral Surgery.................................................       -1.8
Thoracic Surgery.............................................       -1.8
Plastic Surgery..............................................       -2.0
Psychiatry...................................................       -2.2
Cardiac Surgery..............................................       -2.4
Radiology....................................................       -2.6
Podiatry.....................................................       -2.6
Radiation Oncology...........................................       -3.1
Ophthalmology................................................       -3.8
Nonphysician Practitioners...................................       -4.1
Pathology....................................................       -4.2
Optometrist..................................................       -4.5
Chiropractor.................................................       -4.6
Anesthesiology...............................................       -4.7
Dermatology..................................................       -6.2
All Physician Specialties....................................        0.0
------------------------------------------------------------------------
According to the AAD, the proposed changes in the E & M codes specific to dermatology (99201 - 99205 and 99211 - 99215) will remain unchanged (99211) or increase from 9 to 13%. The proposed reductions in the destruction codes will have the following impacts:
------------------------------------------------------------------------
 Code    1996 value    1997 value                Total RVUs  
                       (proposed)      1996       1997 est.     Impact
------------------------------------------------------------------------
17000       0.64         0.36          1.09        0.81        down 26%
17001       0.19         0.14          0.40        0.35        down 13%
17002       0.19         0.14          0.30        0.25        down 16%
17100       0.53         0.30          0.93        0.70        down 25%
17101       0.11         0.11          0.31        0.31        unchanged
17102       0.11         0.11          0.20        0.20        unchanged
------------------------------------------------------------------------
The AAD is participating in direct responses to HCFA as well as through the AMA Relative Value Update Committee.

AAD Survey - Miscellaneous Results

The second part of an AAD membership needs survey, conducted in late 1995 and early 1996, received responses from 2,585 dermatologists. Among the findings:

  • 83% of dermatologists have a computer in their practice (versus 41% in 1991).
  • 36% of dermatologists have access to e-mail.
  • 31% of dermatologists plan to link up to online services in the next year.
  • 43% of dermatologists are interested in receiving CME programs over the Internet.
  • 70% of dermatologists submit at least some claims electronically.
    June, 1996 Thomas L. Ray, M.D. / Dept. of Dermatology / University of Iowa / tray@blue.weeg.uiowa.edu