(6) The American Academy of Dermatology and the Internet: An interview with the current candidates for President of the AAD: Irwin Freedberg M.D.

by Arthur C. Huntley M.D.

Dermatology Online Journal, July 1995
Volume 1, Number 1

Irwin M. Freedberg M.D.

Irwin M. Freedberg, M.D. is the George Miller MacKee Professor and Chairman of the Ronald O. Perelman Department of Dermatology at New York University School of Medicine. He is Chief of Dermatology at Tisch Hospital and at the Bellevue Hospital Center and he holds appointments as a Consultant at the New York Veterans Affairs Medical Center, the Hospital for Joint Diseases and New York Downtown Hospital. Dr. Freedberg indicates that approximately 50% of his time is spent in administrative and teaching activities, 25% in research and 25% in clinical practice as a member of the NYU Dermatologic Associates.

Dr. Freedberg received his medical degree from the Harvard Medical School in 1956 and took his dermatology residency training at the Massachusetts General Hospital, 1959-1962. He is the author of over 110 publications. For further biographical information, see the end of this article.


DR. HUNTLEY: You of course know that the readers of this interview are likely to be computer literate if not advocates of the medium. With this in mind, what do you think is the place of the computer in the teaching and practice of dermatology today?

DR. FREEDBERG: Although the readers of my answers through the email system will all have had experience with electronic communication, I assume that the responses may eventually become available to the entire electorate - thus, these are not responses tailored for only one portion of the Academy membership.

Since the early attempts to bring computer technology to our specialty, through the leadership of my colleague Al Kopf, until the present activities of the Sulzberger Institute, the AAD has been actively involved in these areas. I believe, as I noted in my Position Statement which will be published by the AAD as part of the election procedure, that these efforts must be enhanced. I am not at all an expert in the area but I have tried to expose myself to the potential benefits and problems during the past four or five years and I have concluded that electronic communication will become more and more important to us all in the next several years. There are already significant efforts throughout the world dealing with both the teaching of dermatology and the practice of dermatology and I feel that the Academy should exert leadership in this area to help direct the path which we take. However, this is a wonderful example of the overriding issue which I believe our specialty faces on many, many fronts - the Academy should exert the leadership because the Academy has the strength and the resources but the effort must involve our entire specialty.

A beginning has actually been made already. At the end of May a meeting was held at the SID meeting to discuss this very area - the use of electronic communication in our specialty. I attended as an interested observer. The Academy was represented by the Associate Executive Director and there were a number of interested leaders of our specialty who also attended. There was consensus that such discussions should continue and the Academy will host the next meeting in Chicago during Academy '95. I have also learned, through Tom Ray of Iowa that the Communication Council of the AAD is very actively involved in this area. They are working to get a WWW page up before the Summer 95 Meeting one of their major priorities is to develop an authoritative FAQ that will capitalize on the established resources of the AAD. To me, this is all very exciting.

DR. HUNTLEY: How do you think the Academy should be involved with the Internet?

DR. FREEDBERG: I believe, as a corollary of what I have said above, that the Academy should assume leadership for a Home Page which deals with all the dermatologic resources on the Internet. It is a logical step for the Academy to take, I am told it is not expensive and it will provide an important service for our members and ultimately for our patients - which is actually the only reason for any of our activities - to ultimately improve the quality of dermatologic care delivered.

DR. HUNTLEY: A colleague of mine who is a Family Practitioner and who is also very active running email lists and a gopher site, said that 'there is currently no compelling reason for physicians to use the Internet.' He felt that the available resources on the Internet were not yet of quality and quantity to effect the education or practice of family medicine. If you have had experience with online resources do you agree with that assessment for dermatologists? Do you advocate the use of the Internet by the members of the Academy?

DR. FREEDBERG: Your friend, the family physician, is probably correct. There may not be a compelling reason in the summer of 1995 for physicians to use the Internet but there will be compelling reasons in the very near future. Communication is central to progress in medicine and the Internet provides a fantastic way to communicate efficiently. At this time, the dermatology material which I have seen on the Internet is improving each day and I believe that before too long there will be an imperative. It is for that reason that I believe the Academy should become involved as soon as possible - so that the AAD can help to shape the future so that our members' needs are fulfilled.

DR. HUNTLEY: The Academy seems to spend a lot of effort in various committee meetings. Do you think that some of this activity might be shifted to virtual meetings (resulting in a savings of time and money)?

DR. FREEDBERG:I have no experience with virtual meetings but I know that the Conference Call mechanism works extremely well - especially when the participants have had an opportunity to meet face to face enough times so that they know each other and are able to deal with each others opinions. During my term as Chair of the Commission on Health Policy we used regular conference calls to get our work done and the same is true now of the Executive Committee of the Academy Board. I assume a virtual meeting would be even more successful - whatever a virtual meeting really is.

DR. HUNTLEY: Watching the newsgroups today, one finds a smattering of questions and answers which relate to skin diseases. Most of the answers seem to be provided by specialists in other fields or by generalists. Do you think that the Academy should consider sponsoring a NewsGroup or gopher to provide a better source of information to the lay public?

DR. FREEDBERG: At the present time, as you know, there is beginning to be Internet activity in this area. For those that don't know to what you are referring, the situation is one in which a patient or a patient's relative or a patient's primary physician posts a question about a dermatologic problem. Right now it is sort of a free-for-all which makes the Schock Letter look like a superbly reviewed piece of the medical literature. The Academy perhaps could fill a roll here but the legal issues must be thoroughly defined before any endeavor is begun. What are the liability issues involved??? Obviously, I know nothing about this portion of the situation.

DR. HUNTLEY: In regard to the same news-watch, one notes occasionally dermatologists who answer questions, and perhaps it is my bias, but it seems like some of them have a special procedure or product to "sell". Do you think the Academy should provide any guidelines for posting advice on the Net?

DR. FREEDBERG: If the Academy becomes involved it will have some control over the material on the service(s) it provides. I believe that the control over any wider area than this would not be appropriate according to the First Amendment of the Constitution. As we are learning in some of our other endeavors, guidelines are difficult.

DR. HUNTLEY: Several years ago Al Kopf and Fred Leavitt created an excellent treatment database,Derm/Rx (now nicely maintained by Van Stoecker). It was way ahead of its time in terms of concept and ability of the membership to access. Since this type of information can be of great use to the practitioner and Internet connections seem to be more common among the membership, do you think the database should be opened to Internet access, and if so should that be at no cost to members?

DR. FREEDBERG: I am well acquainted with Derm Rx which has been maintained by the junior members of the NYU Department for a long time. It is "a natural" for the Internet but the questions of costs and charges are things I am not well enough informed about at this time to come to a conclusion. It would be terrific if the Academy could do everything for us without charging but we all know that is not realistic. Someone has to pay the bills and in any organization decisions have to be made about how costs are allocated. The database is very valuable, it costs money to keep it up and I believe that the Academy members who use it would be perfectly willing to support it. It would bring efficiency to what we all do in practice and thus there would be revenues to go along with the costs to the end users.

DR. HUNTLEY: Any thoughts you want to add about dermatology and the information age?

DR. FREEDBERG: My final though is that I hope all of our colleagues who are interested in information will use all the means available to get information about the candidates for the offices and Board of Directors of the Academy, will reach a decision about the candidates whom they want to support and , most importantly, will then vote when ballots are circulated in October. It is important.

If anyone out there in Cyberspace wants to reach me, my email address is irwin.freedberg@mcfpo.med.nyu.edu. I would be pleased to answer any questions or have you visit our departmental HomePage which in the process of being developed or as the aficionados say is "under construction". We are at "http://www.med.nyu.edu/Derm/HomePage.html".

*Dr. Freedberg's professional activities with the Academy include member, Board of Directors, 1991-96, with election to its Executive Committee (1993-96). Dr. Freedberg has served on the following Academy Commissions, Councils, Committees and Task Forces: Chair, Commission on Health Policy (1989-92); Chair, Council on Governmental Liaison (1986-89); Chair, Council on Research (1993-94); Chair, NIADDK Liaison Committee (1985-86); Chair, Committee on Evaluation (1982-1986); Chair, Committee on Research Activities (1980-82); Chair, NIAID Liaison Committee (1977-1980); Chair, Task Force on Health System Proposals (1993- ); Chair, Task Force on DRGs (1983-86); Chair, NCI Liaison Task Force (1983-85); Member, Commission on Health Policy (1993-94); Council on Education (1982-86); Council on Governmental Liaison (1977-86); Priorities Committee (1994-96); Committee on Evaluation (1982-86); Visioning Development Committee and Visioning Implementation Group (1992-93). He has served on the faculty of the Annual Meeting for over 25 years, received a Presidential Citation in 1990 and was chosen as the Livingood Lecturer in 1994.

His other dermatologic activities include: Board of Directors (1970-72), Montagna Lecturer (1980), President (1981-82), Rothman Medal Awardee (1992), Society for Investigative Dermatology; Editor-in-chief (1972-77), Journal of Investigative Dermatology; founding Chairman (1979) Gordon Research Conference on Epidermal Differentiation and Keratinization; Board of Directors (1983-85), President (1986-88), Association of Professors of Dermatology; Treasurer (1987- 92), Board of Directors (1992-97), American Dermatologic Association; Director (1984-94), President (1992-93), American Board of Dermatology; Chairman (1987- 88), New York Academy of Medicine, Section on Dermatology; President (1994-95), New York Dermatologic Society; Chair, Program Committee(1988-92) XVIIIth International Congress of Dermatology.

Dr. Freedberg has served on the faculty of the Harvard Medical School (1962-77) and as Chairman of the Department of Dermatology at the Johns Hopkins Medical Institutions (1977-81). He has been the recipient of research grants focused on the pathways and controls of epidermal protein synthesis since 1962 and recently received a five year renewal of his current NIH grant (1995-00). He has been elected President of the Medical Board and Medical Director of Bellevue Hospital Center (1987-90) and to a similar position at Tisch University Hospital (1991-93). He was elected to fellowship in the American Association for the Advancement of Science (1987) and, in addition to the organizations discussed above, he is a member of the American Society for Biological Chemistry, the American Society for Cell Biology, the American Society for Clinical Investigation, the American Society for Dermatologic Surgery, the Association of American Physicians, the European Society for Dermatologic Research, the International Society for Dermatology, the Pacific Dermatologic Association and the Women's Dermatologic Society. He holds honorary membership in the French, Greek, Korean and Japanese Dematologic Associations, whose Dohi Medal he received in 1992. He is a member of Alpha Omega Alpha and has been listed in Who's Who in America (since 1980) and The Best Doctors in America (since 1993). Dr. Freedberg has served as a member of the House of Delegates of the American Medical Association, representing the Society of Investigative Dermatology, since 1990.

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