Dermatologists to vote on residencies funded by industry

Some dermatologists were upset when the American Academy of Dermatology decided to use pharmaceutical company money to fund extra residency slots. They said the academy moved ahead with the plan, despite a petition calling for AAD members to vote on the matter.

Now the AAD has decided to let members have their say.

The academy in March will ask members to vote on a measure calling for the AAD not to support or fund any initiative intended to influence the size of the dermatologist work force without approval by a two-thirds vote. The measure was proposed by dermatologists who don't want drug companies funding residencies. "The lesson we learned was you probably need to get a pretty good consensus before going forward," said AAD President Clay Cockerell, MD, who practices in Dallas.

Although the AAD is allowing the vote, its board is recommending that members vote against the measure, saying there are enough safeguards in place to prevent conflicts of interest.

The pilot program was intended to fund 10 slots per year for three years. Corporate sponsors contributing funds include 3M Pharmaceuticals, Amgen and Wyeth Pharmaceuticals.

Board members of the nearly 15,000-member academy say the program is designed to alleviate a dermatology work-force shortage by increasing the number of dermatologists.

The academy cites a 2002 dermatology practice profile survey that found one-third of dermatologists wanted to add another dermatologist to their practices and that patients waited an average of 36 days for an appointment with a dermatologist.

Program has its skeptics

But not all dermatologists believe there is a work-force shortage. Some doctors said the same 2002 survey found that half of those polled believed the supply of dermatologists was adequate or excessive.

Pittsburgh dermatologist Orin Goldblum, MD, questions the need for more dermatologists and says that the pilot program offers no guarantee that additional residents will practice in underserved areas.

Dr. Goldblum also has concerns about the funding proposal. "This money is coming in from pharmaceutical companies and it may ultimately influence decisions," he said.

Dr. Goldblum was one of the physicians who circulated a petition seeking a vote on the initiative. More than 400 AAD members signed the petition.

"There was significant discontent among the membership," Dr. Goldblum said.

Michael J. Franzblau, MD, also backed the petition and a vote on the matter, saying AAD leaders didn't inform members adequately about the program.

He doesn't think drug companies should pay for residency slots and is concerned that physicians are losing their independence in making decisions for their patients.

"It's a bad, bad precedent," said Dr. Franzblau, clinical professor of dermatology at the University of California, San Francisco, School of Medicine. "My problem is physicians as a group cannot permit any outside force of this nature to influence our decision-making."

Dr. Cockerell, AAD president, said no additional money will be used to fund more slots.