The American Board of Dermatology (ABD) is grateful to the nearly 2,000 dermatology diplomates who responded to our draft Professionalism Policy survey with thoughtful and usable feedback. Of those, 77% approved of the policy as written in the draft, or with minor revisions.
Your comments were reviewed and considered, and changes were made in response to trends or themes that emerged. Your insights made the policy stronger. The final, updated version was unanimously approved by the Board of Directors and is now posted in the Policy Library on our website under certificate status.
Here are the highlights:
Most frequently, concerns were raised about points being vague or redundant.
The policy item that received the most negative ratings was:
Uphold principles of equity, diversity, and inclusion in the healthcare setting.
Many of you said that this item was too vague. Among other concerns -- it was overly political; did not distinguish between equality and equity; infringed on free speech; was “mission creep;” and/or was unnecessary. Some wondered if the ABD was trying to set demographic standards for a practice’s patient base or employees.
In fact, our purpose was to affirm the position and actions of the vast majority of diplomates – to treat everyone respectfully and be medically prepared to diagnose and treat cutaneous disease as it presents in skin of all colors, types, and ages. We agree that the Board has no political purpose or role, and none was intended by this statement. However, since the original statement raised questions, we tried to clarify our meaning and approved the following language:
Uphold principles of equity, diversity, and inclusion in the healthcare setting with the goal of providing the best possible outcome for every patient.
The item that received the second most negative ratings was:
Avoid public comments providing medical recommendations that are untruthful, fraudulent, misleading, or deceptive.
Some of you felt we went too far and would be “policing” free speech. Others were concerned that we had set the bar too low.
Our intent was to raise awareness that medical statements made by certified dermatologists carry the weight of authority and credibility, and our diplomates should not intentionally give medical advice or information that is wrong or harmful. We know medical advances may disprove formerly accepted practices and have no intention of holding anyone responsible for advice given based on current best practices.
The revised statement says:
Provide information to the public in a factual, truthful, and non-misleading manner that is in keeping with the prevailing science.
To address redundancy, we also combined two statements, clarifying the expectation that professionalism applies to both patients and colleagues. The new statement says:
Act with integrity and exhibit respectful, compassionate, and honest behavior when interacting with patients and colleagues.
Concern was also expressed that the very creation of a professionalism policy by the ABD is “mission creep.” However, as we state in the policy, “Every physician has pledged to uphold the Hippocratic Oath (revised in 1964) or (since 2017) the Declaration of Geneva… as part of the medical profession’s privilege of self-regulation, it is the Board’s responsibility to develop standards and communicate expectations for appropriate behavior.”
The policy is in line with the ABD’s mission of “protecting the public interest by establishing and maintaining high standards of training, education, and qualifications of physicians rendering care in dermatology.”
We dermatologists have been meeting these standards our entire careers. Professionalism is one of the core competencies of residency training that must be fulfilled before taking the certification exam; it has always been part of continuing certification expectations; and it is addressed in our bylaws and in other existing policies. This new policy simply clarifies the expectations for professionalism.
Finally, we noted that 117 responders to our survey (6%) did not support any part of the policy, including the expectation that diplomates won’t cheat on exams. We take this feedback not as a criticism of this specific policy, but as a comment on their level of trust in their Board. Our current efforts to improve transparency are aimed at increasing your understanding of – and trust in – the ABD. We know we will not find common ground with everyone but want you to know that we are listening and encourage you to come to us with concerns. Self-governance of a medical specialty takes time, patience, diplomacy, and common sense.
Thank you, again, for providing your perspectives on this professionalism policy. The Board of Directors is grateful for your time and comments, and the final policy is much better as a result. We hope you will continue to share your opinions so that our Board reflects the values and expectations of the dermatology community. Reach out to us anytime at firstname.lastname@example.org.
The ABD Board of Directors
Mary S. Stone, MD, President
Julia R. Nunley, MD, Vice President
David M. Allen, MD
Bruce Bartels, MBA (Public Member)
Christopher K. Bichakjian, MD
Anna L. Bruckner, MD
Jason Castillo, MD (Young Diplomate Observer)
Keith A. Choate, MD
Karynne O. Duncan, MD
Tammie Ferringer, MD
Mercedes E. Gonzalez, MD
Warren R. Heymann, MD
Christine Ko, MD
Delphine J. Lee, MD
Moise L. Levy, MD
Kanade Shinkai, MD
Allison T. Vidimos, MD
Carl V. Washington, MD
Randall K. Roenigk, MD, Executive Director
Lela A. Lee, MD, Senior Executive Consultant
Stanley Miller, MD, Associate Executive Director, Continuing Certification
Marta J. Petersen, MD, Associate Executive Director, Candidate, Program, and Diplomate Relations
Julie V. Schaffer, MD, Associate Executive Director, Exam Development
The policy clarifies expectations for professionalism that dermatologists meet throughout their careers.