American Society of Dermatology
2721 Capital Ave.
Sacramento, CA 95816-6004
Phone: (916) 446-5054
Message: (561) 873-8335
Fax: (916) 446-0500
American Society of Dermatology, Inc.
A Voice for Private Dermatologists Since 1992

November, 1998

Successful 7th Annual Meeting in Reno

The seventh Annual Meeting of the American Society of Dermatology was, once again, a great success. The meeting was not only informative but fun. But then how can you be in Reno and not have some fun.
Presentations were made on a number of topics all of which were well worth the time and effort to attend. If you weren't there you missed another unique experience which is not rivaled by any other organization. The meeting provided our members with the most up-to-date usable information to help each of us maintain excellence in caring for our patients. Practical information was also featured on how each of us can effectively influence how our legislators vote on critical bills. "The most important thing you can do as a physician is never give up" says Kentucky Senator Richard Reoding. He adds, "stay in contact with your legislators...don't let them forget who you are and who you represent."
Twila Brase, R.N. and President of Citizens for Choice in Health Care, a Minnesota based health care policy organization, spoke on the fact that managed care systems have put patients and primary care physicians in adversarial roles. "Patients may not even know the care they receive is substandard" says Brase.
Sincere thanks to our speakers and to the pharmaceutical companies who contributed to this year's Annual Meeting.
The American Society of Dermatology will continue to provide the most topical and informative Annual Meeting programs possible. Audio and video tapes are now available. An order form can be found on page 5.
Be sure and view the pictures of the annual meeting.

  • Michael Smith, MD, Professor of Dermatology, Vanderbilt University, Nashville, TN
    "Diagnosis and Management of Ichthyosiform Disease in Infancy and Childhood."
  • John A. Marascalco, MD, Grenada, MS
    "My Medicare Carrier Says I Shouldn't Treat That Cancer."
  • Wolfgang Weyers, MD, Germany
    "The Background Events Which Made German Medicine Susceptible to Takeover" and "The Destruction of German Dermatology by the Nazis."
  • Richard Odom, MD, Past President, AAD
    "Diagnostic and Therapeutic Tips For Your Practice" and "Outlook For Our Specialty."
  • Fr. Robert A. Sirico, President, Acton Institute, Grand Rapids, MI
    "Ethical Issues in Today's Practice Climate."
  • Richard Roeding, RPh, Caucus Chair, Kentucky Senate
    "How Practicing Physicians Can Influence Legislation and the Impact of Third Parties on Prescribing Habits."
  • Diya Mutasim, MD, Professor of Dermatology, University of Cincinnati, Cincinnati, OH
    "Serologic Footprints of Auto-Immune Disease."
  • Twila Brase, RN, President, Citizens Council on Health Care
    "Minnesota's Single Payer Experience: It's Effect on Physicians and Impact on Patient Confidentiality."
  • Edward R. Annis, MD, Past President, AMA
    "The New Credentialing Body and How It Will Affect You."
  • Balint Vazsonyi, PhD, President, Institute for the American Founding
    "Renewal of Medical Professionalism."

    Video and audio tape orders are now being accepted.

  • Dermik Laboratories, Inc.
  • ESC Medical Systems
  • Galderma Laboratories, Inc.
  • HGM Medical Laser Systems
  • Janssen Pharmaceutical
  • Medicis Pharmaceutical Corporation
  • Ortho Pharmaceutical Corporation
  • Penederm
  • Person & Covey, Inc.
  • Stiefel Foundation
  • Supergen, Inc.
  • Topix Pharmaceuticals

    Comments made by the attendees were:
  • "Excellent mix of clinical information and politics."
  • "Superb program. A program that would be valuable to all physicians."
  • "Some excellent and inspiring speakers, along with practical clinical pearls."
  • "The variety of topics and the fact there was plenty of time for questions was especially appreciated."
  • "The presentations were subjects not ordinarily addressed in other meetings I've attended."
  • "Great subjects and speakers; very organized, and a great location! Top notch program."

    As excellent as the Seventh Annual Meeting was, planning has already started for next year's meeting. Mark your calendars now for October 1-3, 1999 and join us for the American Society of Dermatology's Eighth Annual Meeting. Watch for the next FrontLine or check back here for the location. Hope to see you there!

    The Future of Medicine

    by Edward R. Annis, MD
    Past President, AMA

    In our society, things don't just happen. It is informed, motivated and active people who persevere until they make things happen. A little history, however short, seems in order.
    It was in 1942 that Sir William Beveredge was able to establish national health insurance for Great Britain. Patterned after that legislation, the Wagner, Murray, Dingell Bill was introduced to the United States in 1943. Little progress was gained despite strong support from multiple union bosses. That support continued and was steadily pursued for reintroduction in 1945, 1947 and 1949.
    With unending labor boss support, augmented by President Truman’s endorsement of A.F.L. President William Green’s efforts, the Wagner, Murray, Dingell proposal reached front page national recognition during 1949 and 1950. This forced A.M.A. leadership, for the first time, to enter active political debate (in spite of the opposition of many members opposed to political involvement) to mount a national educational campaign to convince the American people of the inherent threats to their health care embodied in that legislation. That campaign proved to be successful, and that proposed legislation was defeated.
    In 1957, admitting he had not even read the bill, Representative Aime Forand of Rhode Island introduced legislation to provide health care financed by Social Security. It was introduced at the request of its authors, two executives of the AFL-CIO, Nelson Cruikshank, Director of Social Security and Andrew Biemiller, Director of Legislation. I had several personal contacts with each of these labor leaders during our long battles.
    Supported primarily by powerful Democratic leaders in both House and Senate, the A.M.A. was again successful in preventing the bill from getting out of committees.
    When doctors perceive a successful legislative victory, they congratulate their leaders, and then go back to their agenda of caring for the sick and injured. Labor leaders also return to their agendas, that of raising money for politics and power to elect legislators sympathetic to or at least willing to push their proposals.
    Unable to pass national health insurance, its proponents changed tactics to establish a foot in the door by introducing legislation to provide health care coverage for all people over 65 years to be paid for by taxes on the younger working population. This legislation, introduced by Senator Anderson of New Mexico and Representative King of California, had been trimmed from the Wagner-Murray-Dingell bills by the two men who had been their major craftsmen, Wilbur Cohen and Isador Falk.
    Again, supported by strong House and Senate Democratic leadership and with only tepid support and no arm twisting from President John Kennedy, King-Anderson legislation was defeated.
    It was Kennedy's assassination that set the stage for Lyndon Johnson and his later capitulation to labor leader Walter Reuther.
    Most of the multitudinous problems facing the medical profession had their beginning when labor bosses, after 30 years of unwavering perseverance, finally elected a president beholding to them. Along with the million expended to get Lyndon Johnson elected, on his own, were also elected 51 new members of the Congress who became virtual rubber stamps for his Great Society.
    Johnson had promised labor leader Walter Reuther, an avowed socialist, that if he was elected, he would give King-Anderson legislation (Medicare) highest priority. True to his word, and after arm twisting and threats to some reluctant members of Congress, Medicare legislation became a reality.
    It was significant that, in preparing for the following mid-term elections, labor bosses gave wide distribution to a pamphlet with a front page picture of a joint session of House and Senate with the captions “51 did it.” They bragged of passing all Great Society legislation with Medicare its “Crowning Glory.”
    After my CBS televised debate with Walter Reuther, I met with him at his headquarters at Solidarity House in Detroit. Among other things he promised:
    “We will not stop until every man, woman and child in this country is cared for under a program financed and run by the federal government.”
    Now we are confronted by the current president of the AFL-CIO, John Sweeney, a card-carrying member of the Democratic Socialists of American, who regularly lobbies to expand health care regulation and mandates. Every new mandate raises the cost of medical care with resulting increases in the numbers of uninsured. This, too, is by design because as the numbers grow, it will enhance the claim that only a government controlled national program can solve the problems of the uninsured.
    Labor bosses can accurately attest to 35 years of continuing successes, with few defeats, because of their financial support of those who have provided mostly liberal domination in the Congress.
    Among their successes, labor leaders can count their ability to infiltrate the Health Education and Welfare Bureaucracy (HEW), Health & Human Services Today (H.H.S.). President Johnson appointed Wilbur Cohen to head HEW in 1968. This infiltration has been especially true of HCFA where many workers have been previously indoctrinated with the established objectives of labor bosses. Many of these unelected and unaccountable bureaucrats have been the prime source of the onerous rules and regulations and of the intimidation and threats which now plague the profession.
    Labor bosses get their millions from dues money. They have successfully forced millions of Americans to pay them tribute in order to obtain or hold a job. They succeeded in passing the Davis Bacon Act, requiring union wages (and therefore check-off dues) on all federal construction projects.
    They have succeeded in their drives to destroy the very principle underlying true insurance. In its place they demand first dollar coverage for all health care with the inevitable waste, fraud and abuse which has resulted. So firmly established is this position that year after year in contract negotiations with the Big 3 automobile manufacturers they refuse to allow the issue to even be considered.
    They have also been successful in having union supporters chair the National Labor Relations Board (NLRB).
    The millions available to pursue the objectives of Clinton-Gore type liberals come mainly from labor bosses and trial lawyers whose ultimate goals are consistently inimical to those of doctors and the patients they serve.
    Some evidence of their present power to influence legislation was reported in the Wall Street Journal on April 3, 1998. Legislation for “paycheck protection” to require unions to get permission from workers before their dues could be spent on politics was soundly defeated 246 to 166. Only 3 Democrats defended workers’ rights and, of the 52 Republicans who opposed the legislation, there were 16 original Republican co-sponsors who surrendered to pressure and changed their votes to opposition.
    In March, Clinton and Gore joined John Sweeney in addressing the AFL-CIO meeting in Las Vegas. The fact that John Sweeney was among those chosen to accompany President Clinton during his African tour should alert doctors to the reality that labor bosses and the millions they coerce from workers, via check-off dues from their paychecks, are being accumulated daily to further their desires for national health insurance.
    It was the Lyndon Johnson forced introduction of the Great Society which initiated the forces inevitably destined to threaten the very foundations of the greatest system of medical care ever experienced by any people anywhere in the world.
    Those foundations were freedoms. The freedom of people to choose their doctors. The freedom of doctors to provide the best medical care available and needed by their patients.
    Those Great Society forces of socialism, collectivism and liberalism have been politically advanced on the theory that government knows best and that its goals can be achieved via bureaucratic decisions and directions given the force of law.
    The forces arrayed against us are of political origin. Political leaders were their architects and planners. To change direction and return to basic principles as established by the Constitution and the Bill of Rights will require the election of political leaders possessing honesty, common sense and stamina.
    Medicine’s future, and the future of quality medical care for our patients, depends upon our active involvement in the political process. This requires studying the issues, sharing ideas and giving financial support to those willing to be our advocates.

    Addendum: As of June 5,1998
    On Tuesday, June 2, California’s “Paycheck Protection” bill was defeated 53% to 47%.
    Only two months ago polls indicated upwards of 70% in favor, including union members who believed they should have a choice for whom their withheld dues are spent politically.
    These reports alerted AFL-CIO executive council members to deduct an extra $12.5 million from dues paid by its members across the country to oppose the bill. Additionally, the California Teacher's Association was reported as having spent $6.4 million to defeat the bill. The wall Street Journal reported that $30 million total of union money provided a “6 to 1 union spending advantage that paid for everything from 10,000 TV ads to 59 field organizers, to ads even on Mexican radio stations.”
    The records reveal that in their massive campaign union bosses did not challenge the issue that political contributions should be voluntary, but rather they resorted to their usual scare tactics to mislead the uninformed. They alleged that the bill would threaten Medicare, the minimum wage, good schools, and would cost nonprofit groups much of the money they raise in California. These scares led the California section of the American Cancer Society, American Lung Association, and American Heart Association to capitulate and back the union bosses.
    Despite a law prohibiting federal agencies from spending tax dollars for political purposes, Chairman William Goulda of the National Labor Relations Board not only accompanied President Clinton to California to fight the bill, he had his press office issue a news release and post on the Board’s official website that the bill should be defeated because it would “cripple a major source of funding for the Democratic party, given the fact that most donations by unions go to Democrats rather than Republicans.”
    This distortion of fact and manipulation of falsehoods is characteristic of Union Bosses and is an awakening reminder of how they initiated Medicare and the Great Society, and how they continue to dominate the Democratic party.
    The May 18 national issue of the Washington Times reported that AFL-CIO boss John Sweeney told Democratic Party leaders on May 9 that “he will recruit, train and deploy a grassroots army of union campaign workers in a bid to end Republican control of the House in November.”
    The report continued, “Mr. Sweeney said that the paid force of political field workers would be one of the largest in labor’s history, and the he would begin putting them to work in Democratic campaigns this spring.”
    It appears that John Sweeney is determined to match or better Walter Reuther’s success which lead to the exultation, “51 did it”.

    AMAP & NCQA - Why they're NOT a good idea

    by Holly Fritch Kirby, MD
    ASD President

    The American Medical Accreditation Program and the National Center for Quality Analysis program are objectionable to physicians for many valid reasons.

  • 1)   AMAP was instituted without the prior approval of the majority of physicians, including the 69% who are not members of the AMA. Not only is this a form of taxation without representation, but there is no mechanism for future control of this type of establishment.
  • 2)   These programs are unfunded mandates and potentially very costly taxes upon physicians.
  • 3)   AMAP represents a direct challenge to certification by the American Board of Medical Specialties.
  • 4)   Both programs generate additional wasteful time consuming tasks distracting physicians and staff from patient care. All the arguments against the egregious E & M codes are also relevant against AMAP and the NCQA.
  • 5)   Both create a form of licensing which could restrict trade, namely the ability of a physician to practice medicine. This could result in significant damage to a practice.
  • 6)   There is no "controlling legal authority" over the NCQA.
  • 7)   These programs represent a major intrusion into the physicians' right to privacy as well as the patients' rights to confidentiality with its quality reviews, patient care outcomes, and performance measures for the physician office.
  • 8)   Thomas Sowell has written that the road to hell is paved with good intentions. Once again the "good intention" to protect the public is the ruse, the excuse, for the power grab to control. Control is real ownership of their practices for free to AMAP or the NCQA.
  • 9)   Both have the potential to develop into the JCAHO equivalent for physicians.

    AMAP will evaluate individual physicians in their offices against national standards, criteria, and peer performance in these areas:

  • 1)   Credentials: Education and training, license and registration, work experience, etc.
  • 2)   Personal Qualifications: Ethical behavior, CME participation, involvement in peer review, participation in self-assessment.
  • 3)   Clinical Performance: Processes of care and quidelines compliance for preventive care, early disease detection, and appropriateness of services performed.
  • 4)   Patient Care Results: Effectiveness (clinical outcomes), cost, health status and patient satisfaction.

    The detailed information about AMAP is quoted from the Greater Kansas City Medical Bulletin of April, 1997.

    The American Society of Dermatology welcomes the following new members:

  • Ahsan Abdulghani, MD, New Brunswick, NJ
  • Jamie Altman, MD, New York, NY
  • Joseph Arno, MD, East Brunswick, NJ
  • James Gaite, MD, Cebu City, Philippines
  • Lydia Juzych, MD, Warren, MI
  • Sonia Kapoor, MD, Miami, FL
  • Azin Khan, MD, Coram, NY
  • Denise Mastromonaco, DO, Ridgefield Park, NJ
  • Gerald Peters, MD, Fresno, CA
  • Rachael Reed, Texas Executive, Austin, TX
  • Vanessa Rodrigues, MD, Curitiba, Brazil
  • Amr Sawalha, MD, Irbid, Jordan
  • Amee Shah, MD, Juhu, India
  • David Walsworth, MD, West Monroe, LA
  • Xuemin Wang, MD, Shanghai, China
  • Kelly Warren, MD, Milwaukee, WI
  • Sang Soo Yook, MD, Republic of Korea