Seemal R. Desai,
MD, FAAD, is founder
and medical director
of Innovative
Dermatology, PA, in
Plano. He is president
of the Skin of Color
Society, immediate
past president of the
Texas Dermatological
Society, and member of
the American Academy
of Dermatology board
of directors. He is a
clinical assistant professor in the Department
of Dermatology at UT Southwestern
Medical Center and a member of the DCMS
Communications Committee. 214-919-3500.
www.innovative-dermatology.com.
November 2018 Dallas Medical Journal 7
its standards starting with preparation
and ending with administration.
However, that is not long enough
because some dermatology
preparations are prepared earlier than
one hour before administration, such
as buffered lidocaine at the beginning
of the workday. The AADA is exploring
ways to increase the time exemption
as well as considering preparation-
specific exemptions through
engagement with USP.
WORKING THROUGH THE AMA
Dermatology is well-represented in
the AMA House of Delegates and thus
has been successful in advancing our
initiatives. We have been involved
individually and collaboratively in a
number of significant resolutions that
affect physicians of all specialties,
having brought forth or cosponsored
issues that include:
• Regulation of Physician Assistants.
This resolution, adopted in 2017,
called on the AMA to advocate
for maintaining the authority of
medical licensing and regulatory
boards to regulate the practice
of medicine through oversight of
physicians, physician assistants
and related medical personnel.
Additionally, the resolution asks the
AMA to oppose legislative efforts to
establish autonomous regulatory
boards meant to license, regulate
and discipline physician assistants
outside of the existing state medical
licensing and regulatory bodies’
authority and purview.
• Medicare Access and Children’s
Health Insurance Program (CHIP)
Reauthorization Act (MACRA). The
House of Delegates in 2016 adopted
our resolution that the AMA:
1. Advocate that the Centers for
Medicare & Medicaid Services
implement the Merit-based
Incentive Payment System
(MIPS) and Alternative Payment
Models (APMs) as is consistent
with congressional intent when
MACRA was enacted;
2. Provide for a stable transition
period for implementation
of MACRA, which includes
assurances that CMS has
conducted appropriate testing,
including physicians’ ability to
participate and validation of
accuracy of scores or ratings,
and has necessary resources to
implement provisions regarding
MIPS and APMs; and
3. Provide for a stable transition
period for the implementation of
MACRA that includes a suitable
reporting period.
• Text messaging between physicians,
patients and medical staff, and
the Health Insurance Portability
and Accountability Act (HIPAA). In
response to a resolution authored
by the AMA’s Dermatology Section
Council and presented in 2017, the
AMA Board of Trustees updated
its policy on electronic mail and
text messaging. AMA studied the
medicolegal implications of text
messaging and other non-HIPAAcompliant
electronic messaging
between physicians-patients and
members of the healthcare team.
• Sunscreen use at schools and
summer camps. The AMA House
of Delegates in 2016 passed a
resolution that the AMA work with
state and specialty medical societies
and patient advocacy groups to
provide advocacy resources and
model legislation for use in state
advocacy campaigns seeking the
removal of sunscreen-related
bans at schools and summer camp
programs. Although not an issue
in Texas, other states forbade
sunscreens on campus because of
the possible liability of liquids and
gels. Ingredients in the sunblock
could cause allergic reactions in
other students.
SUPPORTING RESEARCH
IN DERMATOLOGY
Clinically, Dermatology remains active
in basic, translational and patientfocused
research areas. For example,
the FDA has approved multiple novel
biologic therapies aimed at treating
psoriasis and even psoriatic arthritis.
Examples include ixekizumab,
brodalumab and guselkumab. In
addition, skin cancer detection and
early management continues to be
a major focus of many dermatologyspecific
organizations, and the
annual Melanoma Monday initiative,
which occurs every May, has grown
tremendously in media and healthcare
awareness. We continue to work with
the NIH/National Institute of Arthritis
and Musculoskeletal and Skin Diseases
and other groups to help acquire
more research funding for orphan and
rare skin diseases, given that many of
these conditions do not have FDAapproved
therapies. In addition, we
hope that conditions such as vitiligo,
alopecia areata, atopic dermatitis,
and other inflammatory skin diseases
will continue to gain traction in the
research arena, especially given the
recent successes in studying the Janus
Kinase inhibitor class of drugs (JAK).
As a specialty, we remain actively
committed to patient care, clinical
research, and collaboration with the
House of Medicine, and as advocates
for all physicians. As you can see,
advocacy is a passion of mine, and
I hope it is one for you, as well. No
matter what you do in patient care,
please remember that all of us, no
matter the specialty, are working hard
each day to support physicians and
the House of Medicine. I am proud
that in Dermatology, we are helping in
the fight to support medicine, protect
our specialty and preserve our future.
DMJ