Stop Board Certification in Mohs and Dermatologic Oncology

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Preserve the Unity of Dermatology-Oppose Unnecessary Subspecialty Certifications in Mohs Surgery and Dermatologic Oncology and Cosmetic Dermatology

While dealing with the uproar over MOC, The American Board of Dermatology (ABD) is planning a new subspecialty certification: Mohs Micrographic Surgery and Dermatologic Oncology (MSDO).  Subspecialty certification in MSDO by the ABD is unnecessary, divisive, and imposes needless regulation on Dermatology. Creation of this subspecialty will restrict patient access and will limit the practices of the majority of Board Certified Dermatologists.

MSDO will benefit a small minority within dermatology by granting exclusive use of the terms Surgery and Oncology. This will disenfranchise the vast majority of Board Certified Dermatologists who treat numerous cutaneous malignancies every day. It will threaten patient access to care since regulators and insurers are likely to interpret the words Surgery and Oncology in the MSDO certification narrowly. This could result in credentialing and reimbursement difficulties for dermatologists without the MSDO subspecialty certification.  They may restrict those without MSDO certification from performing biopsies, cryosurgery, destructions and excisions in the treatment of skin cancers.  Implementation of this subspecialty certification may also lead to malpractice insurers refusing to insure dermatologists, without the subspecialty certification, for the treatment of skin cancers.

In addition, the public may consider dermatologists without MSDO certification less qualified to treat skin cancers. With our profession at stake, we should not support this subspecialty certification.

As we are in the midst of an ongoing skin cancer epidemic, restricting access to necessary care would be devastating for our patients. For decades, Dermatology residency has prepared dermatologists to diagnose and treat skin cancers extremely effectively using a wide range of methods, including Mohs surgery. MSDO could effectively stop the majority of Dermatologists from using those methods.

Without a public health crisis demanding change, why would the ABD create this new subspecialty? The MSDO subspecialty unreasonably divides a specialty that is at present working well for our patients.

Cosmetic Dermatology subspecialty certification with all of its requirements (fellowship, initial certification, MOC and recertification) will surely follow if MSDO is enacted. Cosmetic Dermatology subspecialty certification was foreshadowed by AAD Past President Brett Coldiron in his January 2015 AAD Member to Member article as evidenced by cosmetic dermatology fellowships being organized and accredited.

We should not support the creation of MSDO subspecialty Board Certification, or any other division of our specialty.

We should maintain our Unified Identity as Dermatologists- The Board Certified Experts in the Medical, Surgical and Cosmetic Care of the Skin, Hair and Nails.

George Elgart, MD, FAAD                                                                                    Miami, FL

James A. Schiro, MD, FAAD                                                                        Hagerstown, MD

My signature below indicates that I OPPOSE the ABD subspecialty certification of Micrographic Surgery and Dermatologic Oncology.


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