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As technology improves and regulations become more complex, what strategies do you recommend for keeping ahead of the curve to build and maintain a successful dermatology practice?

Sandra Marchese Johnson, MD: We like to look at all of our policy manuals in January and strategically plan for the year. We also have goal setting the first staff meeting of the year.

Seemal Desai, MD: Maintaining an online patient portal via your practice website to allow patients to more efficiently interact with the practice.

Gary Goldenberg, MD: Internet marketing and social media are a great way to keep in touch with your patients and market.

Robert T. Brodell, MD: The technology that has the biggest potential to damage quality efficient care is the electronic health record. At this same time, it has the biggest potential to help provide quality care.

Peter A. Lio, MD: There is no doubt that this is increasingly stressful. I think remaining open to change and continually trying to leverage the existing technology to our advantage will be key.

Dina Anderson, MD: I feel that these changes will help keep me ahead of the curve in terms of patient retention and referrals from other patients. I am not planning on keeping up with the regulations for Meaningful Use. It is too time consuming and expensive relative to the penalty that may or may not occur. I am choosing to put my time and resources into making the patient experience a very positive one, from the moment they walk in until checkout.

What do you think is in store for the specialty of dermatology in 2014 and beyond?

Dr. Lio: Everyone is very nervous about healthcare and where it is going. I'm nervous too, but also excited: With great changes there will be at least some good things with the feared changes. My hope is that we will increasingly leverage technology to make healthcare more cost-effective and efficient.

Dr. Anderson: I think these above trends are what many dermatologists will start to adapt as the Affordable Care Act hits and access to branded medication decreases and reimbursements decrease, forcing us to think of alternative ways to keep our practices thriving and our patients happy.

Dr. Brodell: Dermatology will remain the specialty with the happiest physicians and the most satisfied patients, irrespective of the issues created by dramatic changes in the health care system.

Dr. Desai: I think the specialty continues to face threats from external influences, including reimbursement issues, scope of practice, pathology cuts, and SGR reform. As a small specialty, dermatology must be vigilant in standing our ground and thwarting off those who threaten our practice. We need more dermatologists to get involved with advocacy, especially on the state and federal level.

Dr. Goldenberg: Dermatology will continue to evolve and improve with new medications and cosmetic treatments/ techniques. As other specialists, dermatologists should be concerned with continued cuts in reimbursements and burdensome regulations.

Dr. Johnson: I am honored to be a dermatologist. I love what I do. I know there are a lot of changes in healthcare that may positively or negatively impact my enjoyment of what I do. However, I still get to be a dermatologist. It does not feel like work to me. There are always new developments. That is one of the reasons why dermatology is so much fun.

I think we need to preserve our profession. Most dermatologists graduate at the top of their medical school class and are high achievers. We need to work together and not splinter ourselves or be divisive. It makes me sad to see dermatologists compete with each other instead of promote each other. There is a shortage of dermatologists and therefore there is enough skin to go around for everyone. If we start bickering with each other or start splintering off into different subsets of dermatology, it will lower our ability to speak with one voice. I think we need to all work together to promote with one united voice that dermatologists are the experts of the skin, hair, and nails.

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