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Dr. Ackerman has trained residents in dermatology and pathology and
fellows in dermatopathology, given lectures and courses, written articles,
and crafted books. He founded the International Society of Dermatopathology
and two journals, The American Journal of Dermatopathology and
Dermatopathology: Practical and Conceptual, served as President of local,
national, and international societies of dermatology and dermatopathology,
and received awards in recognition of these endeavors.
 Candidates Statement
We are all members of a noble Academy, an institution of higher
learning that was founded principally for the study of all aspects of skin
disease. The word "academy" derives from the name of a garden near Athens
where Plato taught a philosophy predicated on skepticism. During the nearly
30 years that I have studied dermatopathology and practiced it, I have
endeavored to be an academic in this spirit. My purpose has been to
advance, through dermatopathology, knowledge about dermatology and general
pathology concurrent with training residents and fellows about principles
and practice of dermatopathology, and serving colleagues and their patients
by seeking to issue specific diagnoses in language comprehensible to
clinicians. Even as a resident, it had become apparent to me that a truly
academic life was incompatible with a political career; in the former there
can be no compromise with that which one holds dear, whereas in the latter
there is no end to accommodation. It is satisfying to be able to state that
I owe not a single political debt.
How, then, did I come to agree to be a candidate for the Board of
Directors of our Academy? During the last election of officers, I responded
to Pat Engasser's invitation, published in Dermatology World, to call her
at home in order to share with her concerns about the Academy and its
course. She responded graciously and thoughtfully to my volley of concerns
and asked that I detail them in a memo to her, which I did. About a month
later I received a call from Pat who said, in effect, that rather than
continuing to be a critic at ringside, I should enter the ring and run for
the Board of Directors of the Academy. I replied that if nominated I would
do that, and I am grateful to Pat for encouraging me.
In my estimation, the American Academy of Dermatology is the most
important organization of dermatologists in the world. It is much more than
a place where dermatology is learned; it is the crucible in which
principles that guide our specialty are forged, in which matters of moment
for patients and their doctors in the realms of care (authentically human
rather than cynically managed), ethics, and economics are debated, and in
which the needs of the members, the vast majority of whom are
practitioners, should be heard and addressed. The future of dermatology,
including its very existence as a specialty, depends on enlightened,
visionary, and courageous leadership of the Academy.
The American Academy of Dermatology is a great institution whose
mettle will be tested severely in the ensuing years. If it is to act
effectively on behalf of its constituents, more than 11,000 strong, it must
be true to its heritage, resolute in its convictions, and responsive to its
members. Some changes must be initiated if the Academy is to adapt to
changing times and is to evolve in salutary fashion. Although the Academy
must first and foremost be devoted to study, it must also be engaged
vigorously in social, political, and economic concerns that affect
dermatologists profoundly - and it must act to effectuate changes that will
redound to the benefit of physicians and their patients. There must be
mighty efforts to prevent a schism between "medical" and "surgical"
dermatologists so that the union of the Academy is preserved, to make the
Academy even more academic by introducing to programs at the annual
meetings new methods of teaching, novel ideas, and fresh faces, to make the
Academy more democratic by permitting any member in good standing for a
specified number of years to be a candidate for office and for the Board of
Directors, to encourage the Ethics Committee to gird its loins in
fulfilling its own ethical responsibilities, to ensure that there is not
even a hint of conflict of interest between the officers, members of the
Board of Directors, and members of the Advisory Board of the Academy on one
hand and pharmaceutical and cosmetic companies on the other, to facilitate
the Journal of the American Academy of Dermatology becoming the official
journal of the Academy in actuality, not simply in title, with an editorial
policy that reflects the philosophy of the Academy, to maintain regular
surveillance of statements by the news media in regard to subjects that
pertain to the skin and to release corrective statements to the media when
that is appropriate, to monitor the pharmaceutical and cosmetic industries
in regard to false or misleading advertisements concerning products for the
skin and rectify, in print, misstatements by them, and to fight doggedly
any interference whatsoever by the government or by insurance companies in
the practice of medicine.
Whatever the outcome of this election, I will continue to attempt
to advance the interests of our specialty and to do it thoughtfully,
passionately, and unflinchingly.
Response to the Nominating
Committee
The forces that threaten dermatology from without are daunting,
chief among them being managed care with its unconscionable interference in
the right of patients to have direct access to a dermatologist of their
choice, insurance companies with their outrageous interference in the
obligation of dermatologists to manage patients optimally as they see fit,
and the federal government with what I believe to be its unconstitutional
interference in the practice of medicine. The major threat to dermatology,
however, is from within, from dermatology itself, and that danger imperils
the very survival of our specialty. Three of those threats are loss of
compass (dermatology is a profession, cosmetology is not), loss of
commitment to educating residents thoroughly in all aspects of dermatology
and inspiring them maximally (the basics and the grandeur of dermatology
must be the focus of training, not "billable events"), and loss of nerve
(fear of doing the right thing professionally because of economic,
political, legal, and societal constraints). Will dermatologists of the
future do manicures and pedicures, style hair, and give mud baths, or will
they save lives by recognizing melanomas when they are small, flat, and
curable; toxic shock syndrome when it is treatable, and paraneoplastic
pemphigus when internal cancers integral to it are operable?
The Academy can reverse this perilous course by emphasizing the
noble legacy of our forebears and stressing rudiments at the same time that
it gives rightful importance to surgery, by making strenuous efforts to
ensure that every resident attends at least one of the Academy's annual
meetings, and by insisting on leaders who express the loftiest aspirations
of the members and have the capability to fulfill them.
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