PracticalDermatology

Oh, how long I have been waiting to rip into this topic--because East Coast Bias has been making me insane ever since I was a kid in Wisconsin. And it plagued me even today when I got a text at 4 am from the Eastern Time zone, because since they are awake everyone else should be, too. I’m sure all of you out East simply expect everyone to adapt to the master time zone but I am going to put a cork in that idea. And for the time needed to read this, I am disowning all my friends in Eastern Time until the editorial is over and am currently accepting donations to help shut down the Eastern Time zone…who is with me? Yes, I am going to whine, but I am the editor so I can.

We all know that East Coast Bias started from sports journalism, and Wikipedia states it even more boldly as bias “attributed to East Coast sports stories being more repetitive, comprehensive, and exaggerated.” The article points out how “Hockey Night” in Canada almost always involves an original 6 team like Toronto or Montreal even if they are horrible that season, and how Red Sox vs. Yankees, Duke vs. North Carolina, or anyone playing the Patriots gets more commercial hype than any other sporting event involving teams in the other time zones. And as the media outlets are based in major East Coast cities, this perpetuates the bias.

The late Tony Gwynn was a prime victim of reporting bias, as most of the Padres home games started after 9 pm Eastern time so coverage of his talent at the plate by major sports media was limited to when he came East to play…even in the seasons when he flirted with hitting .400. Football and baseball playoffs are easier for the media because there is less potential for an East vs West matchup which always means risk of lower ratings, compared to hockey and basketball which are designed to match the Eastern vs. Western Conference winners.

Let’s be somewhat realistic: many of the population centers, and consequently the business engines, of North America are based in Eastern Time Zones. Outside of the AAD (which fortunately is in central time) most agencies, pharmaceutical companies, advocacy hubs, and other institutions in dermatology function on Eastern Time. Anyone going East feels the pain of losing the day to travel, getting up painfully early, and not being able to sleep at a decent hour, while anyone going West gets the luxury of waking up ahead of schedule and getting to sleep at a decent hour. You’re welcome, and see you in San Diego where I get my revenge.

Unfortunately, the blind spot the East Coast has for the rest of the country got much worse in the virtual world. More and more conference calls and virtual meetings start at 5 pm Eastern time to, as I have been told, “accommodate the majority of attendees” which is absolutely bogus because 2 pm Pacific time is smack in the middle of my afternoon clinic time…but to start at 5 pm Pacific time is wrapped in guilt because that is 8 pm Eastern time when everyone has their pajamas on. Even better are the morning calls that come with invitations for 8 am Eastern time which is 5 am my time. But hey, no problem, everyone should be up…

What can become a problem with East Coast Bias against the middle and west of the country’s dermatologists is apathy…apathy for advocacy, for getting involved with partnerships in research and industry, and with the potential for feeling disenfranchised. The more inconvenient we perceive activities and meetings to be, the more we are going to see attrition from those who feel like they are on the outside. We will lose the potential to develop more investigators, more thought leaders, and more advocates.

We are risking extinction in clinical trials if we do not cultivate the involvement of new, young investigators. But as I pointed out earlier, there are inconveniences of time that occur in the clinic day in other time zones because many of the CROs and sponsors are in Eastern Time. It can be costly in a research day when data capture is down, when labs have to be sent in at a certain time to get processed, and when adverse events need to be reported…but we have to adjust.

I come back to the example of the AAD/A Legislative Conference in Washington, DC, every September, which many dermatologists regularly attend, especially those involved in state and national advocacy or governance. The good news? We are seeing more participation from states with smaller populations in the middle of the country, and hearing loud voices on behalf of their patients and their needs which is exactly what dermatology needs. The bad news? As Washington is on the East Coast, it is easier for delegates from Eastern time zones to attend and we need to make sure that we are all representing dermatology when it matters most.

Sure, I realize my campaign to abolish Eastern Time may not work out, but I am still accepting donations--and yes, I forgive my friends out East, but for heaven’s sake don’t text me at 4 am!