Presidential messages

Presidential messages C o m p i l e d b y D o n a l d C. A b e l e , M . D .

Augusta, GA

E d i t o r ' s n o t e : These messages are from the programs of the annual meetings of the Academy and are reprinted with permission.

The formation of a national association to include all reputable dermatologists and syphilologists appeared for a long time to be inevitable. This assumption was based on the success that followed the formation of similar associations in other branches of medicine. It might have been said that the Section on Dermatology and Syphilology of the American Medical Association fulfilled the need of a large association to which all reputable American dermatologists could belong. In spite of the high standard of its scientific programs this body did not satisfy the natural desire of the majority of men to belong to a restricted private organization. Furthermore, the purpose of the new association was essentially educational but was also expected to offer unusual opportunities for social intercourse. The question of forming an American Academy of Dermatology and Syphilology was formally brought to the attention of the American Dermatological Association by Dr. Howard Fox in June 1936, At a meeting of the Section on Dermatology and Syphilology Howard Fox, M.D. of the American Medical Association in Atlantic City on June President, 1938 11, 1937, the Chairman, Dr. Paul A. O'Leary, appointed a committee of seven to study the advisability of forming an American Academy of Dermatology and Syphilology. The Committee met in Chicago on Sept. 10, 1937, a time that was also chosen for the meeting of the organizing committee of the International Congress. This offered an unusual opportunity for a large group of dermatologists representing all parts of the country to meet and discuss the proposed American Academy. Accordingly with the consent of Dr. O'Leary, the committee was enlarged to include members of the Congress Committee and also Drs. William Allen Pusey and Earl D. Osborne. The combined committee consisted of the following: Drs. Harold N. Cole, HatTy R. Foerster, C. Guy Lane, George M. MacKee, Howard Morrow, Paul A. O'Leary, Oliver S. Ormsby, Earl D. Osborne, Wm. Allen Pusey, Elmore B. Tauber, H.J. Templeton, Martin T. Van Studdiford, Fred D. Weidman, Richard S. Weiss, Udo J. Wile, Fred Wise, Howard Fox, Chairman. A meeting of this enlarged committee was held and it was unanimously agreed that the proposed Academy should be formed in the near future. The American Academy of Dermatology and Syphilology was formally inaugurated and a constitution adopted on January 14th and I5th, 1938 in Detroit, more than three hundred dermatologists being present. The large attendance was made possible by a combined meeting of the Central States, the Mississippi Valley and the Chicago Dermatological Societies, the Detroit Dermatological Society acting as host. It was voted to hold the first annual meeting in St. Louis in November 1938. (Photograph courtesy of Orlando Canizares, M.D.)

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At the time of this, the Second Annual Meeting of the American Academy of Dermatology and Syphilology, the total membership is more than 700. This number represents considerably more than half of the dermatologists in this country. The enthusiasm with which the proposal to found an Academy of Dermatology and Syphilology was received indicated a desire by the majority of practicing dermatologists for refresher courses and opportunities for continuous study. It is to be remembered, however, that this is a new undertaking for the officers and for the members of the Committee on Education, none of whom has had previous experience in the planning of such courses. Accordingly, there may be some features in the program of this meeting that will need to be changed in the future; new courses or themes not at this time included in the program may be desired; more than 3 days may be necessary to cover the material selected for discussion; some of the members may wish somewhat elementary discussions while others may seek more detailed discourses on limited Paul A. O'Leary, M.D. phases of dermatology. As experience and expressions of President, 1939 wishes indicate the need of them, attempts will be made to provide for any necessary changes that will be to the advantage of the majority of the members. The Committee on Education has drawn up a schedule for 5 years, This schedule includes discussion of some of the problems encountered in office practice, opinions on controversial issues, and an effort to bring up to date the newer developments in this and allied fields of medicine. The officers seek constructive criticism of this meeting so that, in future sessions, the Academy will be able to give to its members the type of instruction they desire and so that, also, the meetings will aid in furthering improvement in the practice of dermatology in this country and Canada. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

The Third Annual Meeting of the American Academy of Dermatology and Syphilology is being held in an academic atmosphere, with the dramatic background of a World War. We are indeed fortunate that conditions in the United States permit and encourage the pursuit of scientific studies unhampered by these grave conditions and that in spite of the repercussions in this country of the wars in Europe and Asia, we are still able to gather peaceably and in large numbers to discuss our daily office problems and to increase our knowleclge of useful medical practice. It is the responsibility of those of us who will enter military service to maintain the present high standards of dermatologic practice and research while engaged in military activities and to endeavor to gain for the specialty of dermatology and syphilology the recognition in the military service to which it is entitled and which it was not accorded in the last war. The closing of foreign clinics for postgraduate teaching by the War of 1914 and their impoverishment or collapse subsequent to the war were large factors in furthering the devel-

Harry R. Foerster, M . D .

President, 1940

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opment of the excellent postgraduate schools in dermatology and syphilology now functioning in the United States. The hundreds of American-trained dermatologists, seeking to keep abreast of advances in their field, created the need for this Academy of Dermatology and Syphilology. The enthusiastic support and cooperation that these men have given to the Academy in its formative years is evidence of the need for this organization and proof that it is successfully serving the function for which it was created. A continued and steady increase in our membership roll is an encouraging portent for the future. It is the hope and expectation of the officers of the Academy that the stimulus of this meeting on both student and teacher will result in an increase in the teaching efficiency of this organization and in a continuation of the enthusiastic support and cooperation furnished by the members at previous meetings. This is your dermatologic society, to be conducted subject to your wishes and requirements. To improve its service and usefulness to individual members, constructive criticism is not only freely invited but needed. The original plans and procedures of our "5-year plan" have been repeatedly changed as the advisability for change has been indicated in the expressed wishes of our membership. Each year we will build on the experiences of the past and thus maintain a high standard of derrnatologic teaching and of ethical professional and cordial social relations. We may properly anticipate that this country will become a world center in postgraduate medical education, and when that time arrives the Academy must be prepared to share in those responsibilities and opportunities. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

In a world that seems to be rapidly approaching the chaotic state that existed in the Dark Ages, we are holding our Fourth Annual Meeting of the American Academy of Dermatology and Syphilology. While this is being written the shadow of the Four Horsemen is falling over our couuntry and when you read this the Horsemen may already be riding here. Many of our members are already in the service of our country's armed forces; others are awaiting the call. Nevertheless we must carry on the work for which our organization was founded and there is no doubt in the minds of your officers that we shall carry on. The high standards of dermatologic research and practice can be maintained even though we are forced into the maelstrom of a world war. An excellent program has been developed based on the experience of previous meetings and your officers and committees are always in a receptive mood to receive constructive criticism and suggestions. Do not hesitate to let us know your reactions to the teaching methods, to the subjects chosen for discussion, to the choice of leaders and special lecturers. Richard S. Weiss, M.D. This organization was planned to become the focus of postPresident, 1941 graduate demlatotogic training. It is our opinion that that ideal is being approached and as we pass in review of the programs of the previous meetings we can see improvement in the scope and plan of the postgraduate work provided. We are also well aware that much of it can be improved and we have no doubt that with your cooperation it will be improved as we gain experience tllrough the years. (Photograph courtesy of Morris D. Marcus, M.D.)

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The last Academy meeting was held in New York City in 1941. Because of the war it has been impossible to hold a meeting until 1946. Even now, over a year after the unofficial termination of war, there are numerous difficulties-transportation, hotel accommodations, food, printing, and so forth. Our Secretary, in spite of excellent cooperation of every one concerned, has never had such a monumental task. In spite of these handicaps and the expected increase in registration, there is reason to believe that this meeting will be successful. Through necessity and desire, a number of changes and innovations have been made. Because of printing difficulties it has been necessary to omit from the final program abstracts of many lectures and presentations. In fact, at the present writing, there is no certainty that there will be a final program. In such case, the excellent preliminary program must suffice. It is impracticable to hold clinics for a thousand or more members. Therefore, clinics will be held only for those members who do not have access to large clinics and clinical George M. MacKee, M.D. meetings. President, 1942-1946 Education is the principal objective of the Academy. Each year, as a result of experience and suggestions from members, the program has been improved. Because of changes and innovations, it is hoped that the 1946 program will be even more satisfactory than its predecessors. Because of hotel difficulties and criticisms, roundtable discussions will be omitted. This deletion, together with the changes in the method of holding clinics, has permitted the addition of important lectures, courses, and symposia. During the past 2 years an unprecedented number of physicians have endeavored, unsuccessfully, to obtain an adequate training in our specialty. Almost an equal number have unsuccessfully applied for refresher and special courses. The resources of the country are far below the demand. The Academy program is designed to help the second group. But much more is required. The officers of the Academy, in cooperation with the American Board of Dermatology, are attempting to plan a yearly, progressive, full-time, 2-week course of instruction in basic subjects, under the direction of an Academy Faculty, for those who do not receive such instruction in their residencies and preceptorial training. It is planned to hold the courses at the time and place of the annual Academy convocation plus, perhaps, regional courses at various universities, dermatologie conferences, and centers. It may be possible also to arrange regional refresher and special courses for qualified dermatologists. There has been some misunderstanding about the financial policy of the Academy. Many members believe, erroneously, that an attempt is being made to build an enormous reserve. When the reserve reached $10,000 it was decided to hold it at this amount and to each year spend all money collected. This made it possible to charge only $2.00 per plate for the New York banquet. This year the banquet and entertainment will cost the Academy $7.00 per plate, but the members will pay only $4.00. The social function of the Academy is not essential, but it is important. It was thought that all members should benefit by income above expenses and that reduced individual cost for the banquet would accomplish the purpose. (Photograph courtesy of the American Dermatological Association, J Graham Smith, Jr., M.D., Historian.)

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This is the Sixth Annual Meeting of the American Academy of Dermatology and Syphilology, an organization that has steadily increased in size and prestige since it was founded. We are proud and happy to state that we now have 948 m e m b e r s - - 8 1 7 Fellows, 96 Associates, and 35 Affiliates, and we are confident that the widespread new interest in dermatology and syphilology will bring as many more new members in the years to come. The Board of Directors has decided that the annual meetings shall be held in Chicago until such time as better facilities become available elsewhere. In addition to the excellent facilities available at the several medical schools in Chicago, we have, in the Palmer House, a hotel that is large enough to accommodate our organization without difficulty, and one in which we are sure to find the cooperation necessary to make our meetings a success. Chicago's central Ioeatiort is another point in favor of this decision. This year, there will be several more additions to our conE d w a r d A. Oliver, M , D . stantly expanding educational program. Two courses in histoPresident, 1947 pathology will be offered, one at the University of Illinois under Dr. Fred D. Weidman, and one at Northwestern University under Dr. Hamilton Montgomery. Two new special courses will be offered, one on the granulomas and one on the dermatoscleroses. The symposium on syphilis will be allotted an entire day and the symposium on pharmacology and therapeutics, which has been so popular, will be supplemented with a scientific exhibit on dermatologic pharmacy. The directors are enthusiastic about a new "Information Please" panel and think that it will be very well received. The clinics will be handled as they were in Cleveland last year. There will be three of them, all at the University of Illinois, limited to 70 men daily and to those who have no clinical facilities available at home. It is regrettable, but our group is just too large to work out any practicable method of clinical presentation for everyone. The Board of Directors regrets to announce that general high costs have made imperative an increase in tile annual dues from $10.00 to $15.00. This is not tbr the purpose of building up a cash reserve but is necessary if we are to continue our programs at the same level. In closing, I wish to remind you that the Board of Directors and the Educational Committee desire only to administer the affairs of the Academy according to your wishes, and that your suggestions and criticisms are always welcome. We all hope that you will see and hear many things of value to you at this meeting, but that you will not forget to have a good time. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

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The American Academy of Dermatology and Syphilology was founded in 1938 with the expressed purpose of providing an entk'ely different type of meeting in its field. The stereotyped formal essays and discussions characteristic of the older societies were to be replaced with programs that were to be frankly instructional in nature with graded laboratory courses, lectures, symposia, and informal group discussions. While some societies are exclusive by nature, the intent of the Academy's founders was to make it inclusive so that its benefits woutd be available to all honorable physicians practicing the specialty. Accent was to be placed on serving the youthful not merely those young in years but also those young enough mentally to be hungry for knowledge regarding the most recent advances in therapeutic and diagnostic methods and concepts as well. Those still in training also have been provided tbr, even though not yet eligible for membership, so this organization supplements the training given at the large teaching centers. Our organization was predestined for success from the start Clyde L. C u m m e r , M . D . for it gave its members what they most desired through wellPresident, 1948 planned courses competently conducted by top-flight teachers. The best talent in North America was at its command. Each year changes and improvements are made in the courses. At the coming meeting there will be a new departure in informal discussion groups led by men chosen because of their popularity as teachers. If this feature proves successful and popular, it will be expanded in the future. The scientific exhibits are an integral part of the instructional program. Each year they have improved and this year we expect them to be even more vital. The technical exhibits are not regarded by the directors as a purely commercial adjunct tolerated only for the revenue that they undeniably bring to the organization but as a feature contributing greatly to the value of the meeting. About 50 concerns will make large expenditures to demonstrate to us the latest in pharmaceutical preparations and equipment for physical therapy. Our members are urged to visit each of the exhibits for their own enlightenment and for the sake of encouraging the exhibitors who help make our meeting possible. Last year some of you may have experienced difficulty with hotel reservations. Our capable Secretary has made arrangements with the hotel management and hopes to be able to prevent similar trouble this year for those who come to Chicago with confirmed reservations. (Photograph courtesy of the American Dermatological Association, J Graham Smith, Jr., M.D., Historian.)

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The Eighth Annual Meeting of the American Academy of Dermatology and Syphilology finds maintenance of the steady growth, which has been characteristic of the society since the organizational meeting in 1938, and which has resulted in a total membership of 1142 at present. The Academy has remained faithful to its original objective of presenting a well-rounded educational program with features so varied that everyone interested in the specialty may find something to attract him. Because of this flexibility in its programs, frequent changes are made, both in subject matter and in the leaders of the various courses and symposia. The Committee on Education welcomes suggestions and criticisms from the membership with regard to the program, as only in this way can it best meet the wishes of the members. At this meeting, you will note in the accompanying program that many of the special courses are to be presented this year as symposia, thus eliminating the payment of extra fees for these special courses, Only presentations requiring laboratory Francis E. Senear, M.D. facilities or those given to small groups remain as special President, 1949 courses. The modest increase in dues to $12.00 per annum was largely due to this change in procedure. This will be the third successive meeting to be held in Chicago. Undoubtedly, many of the members would welcome the opportunity to visit other cities, but under the present conditions, Chicago has been the only city where sufficient facilities, including those for the presentation of clinical cases, have been available at a reasonable cost. At this meeting, there will be repeated the type of roundtable meetings that were instituted last year and that received much favorable comment. These meetings are designed to offer a number of opportunities for members to bring up for discussion any topic that they may wish to have considered, and all of those present are urged to volunteer discussion or questions. This type of roundtable discussion is intended to be different from the older type, at which a single stated topic was presented chiefly, if not entirely, by discussants selected in advance. Both the scientific and the technical exhibits are important features of our meeting. The scientific exhibits are of uniformly high quality, and have required the expenditure of considerable time and effort on the part of the exhibitors. The subject matter, covering the scientific sessions in a most desirable manner. The technical exhibits are enjoyed by the membership, and we should bear in mind that a considerable portion of the expense of holding the meeting is met by the fees paid by these exhibitors. The cooperating firms judge results by the number of members who register at their booths. It appears to me that the Academy also has one other very vital function. The increase in the number of dermatologists in the United States has been so vet3, rapid that it is now much more difficult to become acquainted with your colleagues from the various sections of the country than formerly was the case. At no other dermatologic meeting is there offered an opportunity to extend your acquaintance with your fellow dermatologists equal to that presented at the Academy meeting, where we are all housed in the same hotel for from 4 to 6 days with sessions morning, afternoon and evening. In conclusion, may I call your attention to the fact that each year the printing of the rosters and the programs becomes increasingly expensive. You are urged not to misplace the former, and to bring the latter to the meeting with you since replacements will not be available. (Photograph courtesy of the American Dermatological Association, J Graham Smith, Jr., M.D., Historian.)

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The Ninth Annual Meeting of the American Academy of Dermatology and Syphilology finds it a growing, lusty educational institution. The membership at the time of this meeting is approximately 1400. The phenomenal growth of the Academy is in itself unimportant. However, it reflects the interest generally of dermatologists and syphilologists in adequate educational facilities in a common meeting ground where scientific information pertaining to our specialty may be made available to all. Furthermore, the Academy has given any dermatologist a chance to contribute to the general fund of knowledge through the medium of the informal discussion group. Because of the great demand for this type of program, the Committee on Education has seen fit to greatly increase the number of informal discussion groups throughout the meeting. As announced last year, the teaching clinics have been discontinued. In their place, the Committee on Education had planned a full day of colored television presentation of clinical Earl D. Osborne, M.D. dermatology and syphilology. Smith, Kline, and French had President, 1950 graciously offered to supply the colored television with all the necessary technical assistance. However, the AMA suddenly decided to shift its interim meeting from Denver to Cleveland and to hold it during the same week as our Academy meeting. This caused Smith, Kline, and French, through no fault of their own, to cancel their program with us. Perhaps we are fortunate because some of our men who have had experience with colored television have been extremely dissatisfied with the sharpness of detail of skin lesions as seen through the medium of television. Smith, Kline, and French have expressed the opinion that within another year or two, better lenses will have been developed allowing for much sharper detail of skin lesions as seen on the television screen. The Committee on Education has transferred all special laboratory courses to the Saturday and Sunday preceding the formal opening of the annual session. This is to give all members an ample opportunity to enroll in any laboratory course without interference in attendance at the regular symposia. A great deal of time and expense goes into the preparation of each special course by the men in charge. Because of the rapidly increasing importance of bacteriology of the skin, it is urged that more of our members take the opportunity to enroll in this course and it is certainly the responsibility of teachers of dermatology to urge their students to enroll in this course. Attention is also called to a new special laboratory course on embryology and anatomy of the skin. The Committee on Education has started this course because of demand for it on the part of men in training. This course will be developed and expanded as rapidly as conditions permit. Last year the Board of Directors saw fit to establish a fellowship in dermatopathology at the Armed Forces Institute of Pathology. This is in keeping with the action of other academies and scientific societies. Our Committee on Pathology will have full control in the running of this fellowship. It is with utmost humility and with a great sense of appreciation that the author thanks the Academy members for this expression of appreciation of his efforts of the past by naming the fellowship after him. It is good for the Academy to change its officers frequently. A 5-year term is long enough for a Secretary-

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Treasurer. We need the introduction of new ideas by men of high caliber and our ranks are full of these men. Perpetuation in office is the quickest and most effective way to stifle progress in an educational institution. As the work in the office of the Secretary-Treasurer becomes heavier and heavier with the growth of the society, there is an increasing tendency to look for the easy way out and hire a full-time Medical Director. This again, is a fatal step leading eventually to mediocrity. It is far better, according to the experience of other organizations, to hire more nonprofessional secretarial assistance and keep the running of the educational system in the hands of practicing dermatologists. Our present Constitution was well designed for this policy. Each year, the author is asked by many members regarding the feasibility of holding our annual meeting in some other city than Chicago. Careful investigation by other societies and practical experience by your officers and committees has demonstrated that it is impossible, at the present time, to hold a large educational meeting in any hotel in this country other than the Palmer House. The cost of meeting rooms, the accessibility of scientific apparatus and of medical teaching facilities, without which our meeting would not be a success, are other factors of great importance. Constructive criticism is always needed and appreciated. The officers and committees carefully consider each suggestion. Send your suggestions or criticism to the Secretary-Treasurer. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

The American Academy of Dermatology and Syphilology. with a membership that now approaches 1500, is the largest dermatologic organization in the United States, if not in the world. To anyone who has had an opportunity to observe the Academy in its early formative years, its present size, and particularly its growth since the War, is most gratifying. With an organization of this size and influence, one is increasingly conscious of the responsibility placed in the hands of the Of_ ricers and Directors and the various committees. Here is an opportunity not only to serve as an educational organization for specialists in dermatology, but also to contribute significantly to medicine and science as a whole. Two new committees have been authorized and appointed during the past year. The first is the Committee on Military Affairs in the Armed Forces, under the chairmanship of Dr. Arthur C. Curtis. With the present enlargement of the Armed Forces, considerable numbers of younger dermatologists will inevitably be called to active duty. These members deserve any Donald M. Pillsbury, M.D. assistance that the Academy can give in furthering their asPresident, 1951 signment insofar as possible to places in which their special skills can best be used for the health of the American soldier, sailor, and airman. In addition, with increasing recognition of dermatologic disease as a very significant source of disability in the Armed Forces, studies designed to lower this disability are urgently needed. Another committee has been appointed at the request of the Food and Drug~ Administration, which desires to avail itself of advice from the Academy on some of the large number of dermatologic problems coming under its purview. This committee is under the chairmanship of Dr. Norman R. Ingraham, Jr. Similar advisory committees to the Food and Drug Administration have been formed by Academies of other specialties of medicine. The Committee on Education, under the chairmanship of Dr. Earl D. Osborne, has made a number of changes and additions in the program of the Academy for this year. It has followed the tradition of giving adequate opportunities for presentation of new ideas by all members who have done significant clinical or investigative work, and of extending invitations to workers in other fields of medicine, or in the basic sciences, to present work that has broad or specialized application to diseases affecting the skin. The program of the Academy inevitably reflects to some extent the declining incidence of syphilis in many parts of the United States, and the paucity of cases of this disease at many large medical centers. Care nmst be

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taken, however, not to consign syphilology to premature oblivion. Sporadic cases will undoubtedly be seen in all centers, and dermatologists must serve as physicians with a constant "index of suspicion," lest the syphilis in these patients remain undetected. In addition, venereal diseases continue to represent a very considerable diagnostic problem in the Armed Forces. The program of the Academy reflects the increasing interest in basic and applied principles relating to skin cancer. This problem is one of increasing importance both because of cancer detection campaigns that arc continuously being carried out in all parts of the country and because the increasing mean age of the population will inevitably result in a much higher proportion of patients with premalignant and malignant lesions of the skin. In this connection, and purely as a personal observation, I would express some concern at the trend toward excessive centralization of the treatment of skin cancer, which is in evidence in many large medical institutions, with the apparent active support of certain national organizations. This trend is toward the restriction of management of cancer of the skin, and even of benign skin lesions, to certain highly specialized groups employing methods that at times seem needlessly complex and expensive. The problem of adequate management of cancer of the skin will not be solved except through dissemination of the proper methods of diagnosis to all physicians, and increasing availability of treatment of cancer of the skin in its earliest phases. Dermatologists will inevitably see more patients with cancer of the skin than any other group of physicians. There is a clearly recognized responsibility on us of adequate education of ourselves, and of affording to dermatologists-in-training an opportunity to observe and participate in the management of skin cancer. These opportunities for training would seem to be decreasing in some larger medical centers at the present time, and this would not appear to be an entirely wise policy. As has been so abundantly demonstrated in the case of syphilis, cancer of the skin will not be controlled unless more and more physicians are trained in the early recognition and management of it, and the methods of treatment simplified insofar as may be consistent with adequate standards of cure. Your Officers and Directors are continually desirous of constructive criticism. Such criticism is more easily considered if it is made in writing to the Secretary-Treasurer. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

It is physicially impossible to welcome each one of you to this 1952 meeting, the Eleventh Annual Meeting of the Academy, but it is my hope that this message will act both as an invitation to attend and a welcome to each one of you who does attend. The purpose of the Academy, as our Constitution states, is an educational one and our programs over the years have been formulated with this purpose in mind. Alterations in the program from time to time have been made in the interest of providing more knowledge to a larger number. This year the Committee on Education plans to stimulate interest in the techniques used in dermatology. Techniques frequently become individualized but much can be learned from the methods used by other dermatologists. First, there is a special course in research technique for those who are research minded. Second, among the seven new round table panels on Wednesday afternoon will be a discussion on radium and x-ray technique. Each of these new round table panels will provide for a C, Guy Lane, M . D . broad coverage of the particular subject of each panel. Members President~ 1952 will undoubtedly suggest to the Committee on Education subjects for further discussions of this type. Among these round table panels is the subject of undergraduate teaching of dermatology and syphilology. If the answers in State Board examinations to questions on dermatology are any criteria, the average young physician should know more about cutaneous disease. It seems reasonable that a discussion of the principles and methods of teaching will result in raising the standards of presenting cutaneous diseases to undergraduates and promote a wider assimilation of better methods by instructors in dermatology. In general more time is desirable for teaching undergraduate dermatology and perhaps later the Academy can put its influence behind such a recommendation.

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With the establishment last year of the Advisory Committee to the Food and Drug Administration and the Committee on Military Affairs there are possibilities for the education of dermatologists ill some of its larger aspects. The Academy has become the largest dermatologic society in the country, perhaps anywhere, and represents dermatology as a whole. Thought should be given to the relationship of the specialty to other fields, to medical education, and even to the public--i.e., public relations. It would seem advisable to explore our relations with the United States Pharmacopeia, the National Formulary, the Council on Pharmacy and Chemistry and the New and Non-official Remedies, the Council on Physical Medicine and Rehabilitation, etc., to ascertain whether some more definite relationship would be of mutual aid both to such organizations and to the Academy and its members. It seems possible that similar advisory committees can be of definite value in dealing with problems with cutaneous aspects under consideration by these bodies and that our members will obtain benefit from reports of these committees on activities relating to our specialty. The Council on Industrial Health has recently sought our help in establishing a joint committee on industrial dcrrnatoses with other dermatologic organizations. Such a commktee will serve as an advisory committee to that Council on occupational dermatoses and their management in a much more intimate manner than has existed heretofore. The nondermatologic, or better the semidermatologic relationships of the Academy today, in view of its size and importance, deserve careful consideration as a part of its educational function. Financially the Academy is sound as evidenced by the Auditor's report. I am deeply appreciative of the work of the other officers and the members of the Committees who will make this Academy meeting another success. Please remember to send your constructive suggestions to the Secretary during or after the meeting. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

With this issue of your program your officers welcome you to the Twelfth Annual Meeting of the American Academy of Dermatology and Syphilology. The growth in numbers and the unflagging enthusiasm of the members are the best evidence that the Academy is a vital postgraduate teaching institution, and proof that it has not succumbed to the dry rot of overorganization. In an age of specialization it is essential that the specialists themselves meet frequently to exchange experiences, to assess new methods of diagnosis and treatment and to broaden their background in the basic disciplines. Dermatology is concerned not only with the external manifestations of disease but with the patient as a whole. All phases of internal medicine, psychiatry, hematology, the study of systemic infections, endocrinology, to mention only a few, are germane to our specialty, Each year we hear reports from acknowledged leaders in the related fields. Any medical specialty becomes barren unless sustained by an increasing understanding of the basic sciences on which all Michael tl. Ebert, M.D. practice of medicine rests. The practitioner must constantly President, 1953 assess his daily problems in terms of physiology, biochemistry, microscopic pathology, and microbiology. Only by repeated infusions of new knowledge can his interest be revived, his therapy rationalized and his efficiency increased. The Academy has indeed been fortunate in its leaders. They have been men of vision and energy who have given unselfishly of their time. By careful planning and hard work they have organized a cunieulum that compresses a maximum of values into a minimum of time. However, we are also a democratic organization. Suggestions and sound criticism are welcome. I assure you they are carefully considered. They help to determine the shape of things to come. Like all healthy organisms the Academy must not only grow but learn fi'om experience. Changes are made each year. You will note the current emphasis on round table panels that proved so successful last year. They

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encourage a closer contact between the members and the panel directors. Dr. Paul O'Leary will conduct a panel on "Medical Writing," a subject that is much in need of elucidation by an expert. The course in research methods introduced last year seems to fill a need and to have great value. It will be continued this year. The field of parasitology in its dermatologic aspects will be developed in a symposium by Dr. Orlando Canizares. Dr. Eugene Farber will conduct a symposium on Peripheral Vascular Diseases, which should be very profitable. There is no better way to cement our friendship with other nations than by colhtboration and exchange of ideas in scientific fields. The Committee appointed to revise the constitution is attempting to make some provision to include in our membership recognized leaders in the field of dermatology outside the North American continent to put our membership on an international basis. The officers of the Academy are aware that there is considerable interest among the members in the subject of group insurance. As a consequence a Committee on Insurance has been appointed to thoroughly canvass this field. You will hear more about this when we receive their report. We believe the program as arranged will fulfill your expectations. Your cooperation can make this meeting an outstanding success. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

In the past, 12 Presidents have told you of the continued growth and improvement of our Association. It is a 12-time told tale of achievement and service. This year it is my privilege to report continuation of the same. Socially, the weather is changing from balmy to torrid; financially, the ink is black; educationally, and most important of all, the skies are azure. In short, the overall picture has not changed signilicantly during the past year, with one important exception. It was a shock that our Secretary-Treasurer, Dr. John E. Rauschkolb died; he was comparatively young, and death was so sudden. His administrative talent was such that there was not a ripple in the conduct of our affairs when he took over the reins from Dr. Osborne over 4 years ago, and moreover, it was a very large pair of shoes that he had to fill. Dr. James R. Webster, The Assistant Secretary-Treasurer, was elected Acting Secretary-Treasurer. It was uncanny to observe the manner in which he anticipated contingencies, and gratifying to learn of his energy and good judgment. Once Fred D. Weidman, M . D . again, the transition in management of the most important and President, 1954 complicated office in our organization has been effected smoothly. Dr. Webster's report in this program leaves nothing factual for me to add. I wish to take this opportunity, though, to share certain "inside" information with you that 1 have gained at meetings of the Committee on Education, the body that is the lifeblood of out' Academy. I wish it were practicable for every member to attend the sessions and learn for himself how complicated the factors are in our Educational Program and how conscientiously and wisely they are dealt with. To mention only a few, "roomage" is one; the supply of sizable rooms is limited and presentations have to be jockeyed accordingly. "Conflicts" is another; that is, a popular topic like dermatoses of the hands will deflect attendance from certain contemporaneous presentations that should not be neglected. "Sta[iag" is a third, i.e., a subject may have such a limited appeal that it will cease to attract after the third or fourth year and will have to be replaced. Change is mandatory in the schemes of many things to maintain virility. Fourth, means have to be devised tbr identifying those teachers who are found wanting in one way or other in their presentations. This has been accomplished by a team of inspectors, which works like the secret board of judges at Scientific Exhibits, and results in gradings that are often surprising but always beneficial to the cause. In short, as part of my responsibility to you, I report that your Committee on Education is doing everything humanly possible to m a k e t h e Program of the utmost value. It is a religion with its members, and I want to grasp the opportunity now to compliment Dr. Earl Osborne as the original Chairman of this Committee for tlae

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vision, clear thinking, judgment, and devotion that made him the foremost member in the success of this Academy. The foregoing paragraphs are not an apology; they merely constitute a statement. Members are still urged to drop their comments into the "suggestion" box in the front office. They" are typed verbatim in the agenda for the next Committee meeting and analyzed and applied in open session. Please take this seriously and join your fellow members in submitting your considered judgment about those phases of the program that appeal to you. As to finances, I wilI give simply a bird's eye view in three or four glances. First, the magnitude; the turnover in the Secretary-Treasurer's office, counting income and outgo, plus our more or less fixed assets, is $I10,152 per year, and the gross cost of the annual meeting alone is $38,496. Second, with all this, the net "income" per year is only about $2,500. This means that moneys received are plowed back almost wholly into returns for the member's dollar. Third, our backlog (irt U.S. obligations) is not quite equal to our annual overall expense; in this light, we are not as rich as might appear at first inspection of the Secretary-Treasurer's report. We are quite safe, though, and your Directors have never been impelled to cut any corners in the educational program in favor of building up the surplus. In fact, they have gone on record against it. Finally, on behalf of the Officers and Directors, I thank the membership for the appreciation of which I have learned in person-to-person conversation. I have never hear a "gripe," so to speak, significantly registered by a member. The only gripes have been within Committees, and since they were part of the work "in the family" and frequently justified, they were symptomatic of good health, and a good thing to get rid of. Your Academy is in the best of health. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

The Fourteenth Annual Meeting of the American Academy of Dermatology and Syphilology finds your Society in the enviable position of being referred to as one of the best organized and educationally successful of the many similar scientific organizations. During the past year the newly elected president of one of our older and larger societies said that when he had been a guest speaker at one of our forums he was impressed by the quality of the exhibits, the chan~cter of the programs, and the large percenlage of the society's membership who attended each year. His interest was to use much of our organization's plan to rejuvenate his own society. We should take pride in an achievement that is good enough for others to copy. Our society's success has been due to the unstinted generosity of its members in contributing what they can to make its meeting interesting and educational and to the founder vision and continuous interest in making its meetings better each year. During the past year Dr. James R. Webster has become the Secretary-Treasurer of our Society and Dr. Robert Kierland the Arthur C. Curtis, M.D. Assistant Secretary-Treasurer. Your Board of Directors acted President, 1955 well and wisely in their choice of this team. It is their energy, judgment, and continual watchfulness of the Academy's activities that make out' meetings so enviable. The Academy of Dermatology and Syphilology is young. The need for one who has an interest in and is charged with compilation of its history has not, until now, seemed necessary. Each year we leave behind nothing but memories of some of those who did so much to make possible the dream of our founders. It is now time to officially appoint someone who is qualified to record in our Archives our early beginnings, growth, and maturity before the facts and documents arc lost. You will notice with our program a proposed amendment to the Constitution of the Academy to provide for such an appointment. Suggestions are often heard that the meetings should be held in other cities so that members would have the opportunity of knowing other cities and different climates and seasons. Your Board of Directors is conscious of these requests and has seriously considered all of them. After each discussion, however, the facilities needed, expense for exhibit space, room reservations required, and convenience of location make most of such requests

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Presidential messages

impossibilities. Your society has no fixed idea in this regard but to make the Academy a traveling one would increase costs, increase dues appreciably, and lead to decentralization of many of the Academy's programs. As a result Chicago comes ap with the bouquet each year. There are few if any places, as the American Medical Association has found, that can handle so well all the functions of your Academy. The backbone of the Academy is its scientific program. The group that takes the responsibility for the organization of new programs and deletion of old ones is the Committee on Education. This Committee consists of active, creative, and educationally experienced men. They should not have the responsibility of tile entire programs in their hands. You, the academician, can be of great help to this committee and your society by making suggestions for both programs and speakers for future meetings. You may well know of important studies being done; excellent speakers on dcrmatologic or allied fields or interesting exhibits you have seen of which the members ol the Committee on Education are not aware. Use the "suggestion" box in the registration area for your suggestions and help continue our growth and quality. Each year our Academy grows and we make new friends. Each year we also lose old ones who have been, in many instances, those we regard with utmost esteem. Your program with its black bordered pages lists those individuals each year. May the list always be small. On behalf of the Officers and Directors of your Academy may we thank you tbr the privilege of representing you in the world's best dermatologic organization. By maintaining our interest in and attendance at our Academy meetings we will ever be the most important source of continuing education in our profession and specialty. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

The American Academy of Dermatology and Syphilology was founded in Detroit in 1938. Annual sessions have been held ever since with the exception of the war years of 1942 to 1945 inclusive when medical meetings were temporarily abandoned. The next meeting of the Academy in December 1956 may therefore be considered the fifteenth annual meeting or the fourteenth teaching session, since the first meeting was organizational. Since its inception, the Academy has maintained a vital role in the continuing education of practicing dermatologists. [n its many-faceted approach to postgraduate teaching, the Academy organizes a program and provides facilities for the acquisition of knowledge in a wide range of fundamental or basic subjects as well as in clinical dermatology. Also of great importance is the opportunity afforded the practicing dermatologist to come into direct contact with the teachers and research workers who are making current history. Truly there is no excuse for dermatologists in even smaller centers to be out of touch with the George M. Lewis, M.D. latest advances. The splendid attendance, which increases each President, 1956 year, attests to the success of this phase of Academy activity. Currently there are 1860 members in our organization and at the 1955 session 1167 members and guest dermatologists registered at and attended the meeting. Because the Academy sessions represent a pooling of resources of many individuals from many sections, comparable opportunities to some of the courses and symposia are not available in any single institution offering graduate instruction. The Academy therefore provides a supplement to the training of graduate students, which is of inestimable value. Especially in institutions where the number of staff members is limited, a fresh point of view is often decidedly stimulating and rewarding. The Academy leans heavily on the generosity of its more talented members. It is indebted to them for the success it has enjoyed. One of the sidelights of this is reflected in the development of many of the younger men in our specialty. For them the Academy has been an opportunity to work devotedly and conscientiously. Given the opportunity they have fulfilled their early promise and have advanced in stature and in recognition by their colleagues.

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While the annual meeting is the most important function of the Academy, less publicized but none the less vital acti.vities proceed throughout the year. The Education Committee plans carefully and exhaustively for the program of the annnal meeting. The Committee on Scientific Exhibits, the Director of Technical Exhibits, and many other committee members work long and arduously in the interest of the Academy. There is a trend to expand the activities of the Academy and to deviate from the avowed purpose of being "purely educational." Two new committees were appointed this year; one on Nomenclature and the other on MedicaI Economics. The Advisory Committee to the federal Food and Drug Administration has been quite active in opposing the effort to legalize the selling of hydrocortisone preparations across the counter. Our Committee on Insurance has implemented a health and accident program and is investigating plans for other group coverage. In addition we have a Committee on Military Affairs, a Committee on Public Relations, an Advisory Committee on Dermatologic Vehicles, and a representative to the Section on Contactants of the American Academy of Allergy. All of these are desirable. It would appear logical for the Academy to continue to assume the lead in promoting activities for the welfare of dermatology and of dermatologists. The finances of the Academy are sound. During the past year there was a small surplus. Our annual meeting is heavily subsidized by the technical exhibitors so that our fees are quite reasonable and those attending the annual session do not have to pay for everything received. The members of some national organizations in other specialties are not so fortunate. Mounting costs reflecting the current inflationary trend and also resulting from tile expansion of activities partially enumerated above makes it desirable to review carefully our plans for the future. An amendment to the constitution to be introduced for action by the members at this meeting would abolish the limit of $15.00 on annual dues. This would appear desirable so if expenses mount further, the Board of Directors would be empowered to act appropriately. From the first, it has been the policy of the Academy to hold onty a small cash surplus for emergencies and not to build up idle capital funds. There is every reason to believe this policy will continue. The retirement of" Clyde L. Cummer as Director of Technical Exhibits is noted with regret. His many years of devoted service to the Academy will not be forgotten. Dr. Earl Osborne continues to contribute effectively and intelligently to the success of the organization. As in most other societies, the Secretary is the key man. Our Academy has bad only three secretaries, Dr. Osborne, Dr. John Rauschkolb, and the present incumbent, Dr. Webster. All three have been devoted and have given of themselves without stint. It has been a pleasant experience to be associated closely with Jim Webster during this year. His exhaustive knowledge of Academy affairs and his thoughtthlness have simplified my work immeasurably. He has been ably assisted in his arduous duties by the Assistant Secretary, Dr. Robert Kierland. [ krtow I speak for the entire membership in expressing to our colleagues in Chicago the appreciation of the Academy for their great generosity in being perennial hosts. This will be the ninth successive year that we have met in Chicago. Let us make it the best, yet! I hope to see you personally at the meeting. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

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Presidential messages

The Sixteenth Annual Meeting of the American Academy of Dermatology and Syphilology finds this truly national organization still growing at a rate that astounds even the most optimistic of its founders. The total membership is rapidly approaching the 2000 mark. Ten years ago there were 948 members. One might say without fear of contradiction that it is not only the largest but the most active and vital organization in the world devoted to our specialty. Last year our annual meeting was attended by 1248 members and dermatologists in training. Incidentally, it is of interest to note that in the past year only a very few members were dropped for nonpayment of dues. Why and how has our Academy achieved such success? The reasons are many. Foremost is the fact that the Academy fulfills its primary purpose, which is the education of its members. This is accomplished by several means, which include special courses in the fundamental or basic sciences such as anatomy and embryology, bacteriology and virology, mycology, patholNelson P. Anderson, M.D. ogy, and x-ray and radium therapy. Research methods in derPresident, 1957 matology appeals to either those with an investigative aptitude or those who want to learn more regarding fundamental research technics. The recently added course on surgical skin planing has filled anccd for the dermatologist who employs this modality. The various symposia on physiology and chemistry of the skin, hereditary dermatoses, cutaneous allergy, internal medicine and cutaneous disorders, the cutaneous granulomas, fungus infections, surgical, physical, and radiation therapy, industrial dermatoses, syphilis, diseases of the scalp, uncommon dermatoses, pharmaceutical therapeutics, disturbances of pigmentation, dermatological parasitology and tropical diseases, and the reinstituted session on psychosomatic aspects of cutaneous disease are designed to present subjects of both general and particular information of value to the members. The various panel discussions on photography, eczematous eruptions of the hands, techniques in the application of x-ray and radium, military dermatology, infantile eczema, light sensitive dermatoses, the diagnosis and treatment of cutaneous malignancy, and a new panel on diseases of the mucous membrane are designed to cover common problems that the dermatologist meets in his everyday practice. The correlation of clinical manifestations with microscopic pathology is a feature of the Clinico-Pathologic Conference, which appeals to many members. The assembling of 90 to 100 such cases with appropriate photographs and microscopic slides is unequaled anywhere and is an "iconographia" of particular excellence. The informal discussion groups are of special value in enabling small groups of members to meet with nationally known leaders in dermatology and to discuss their problems in a practical manner. Last, but not least, in our educational program are the special lectures. This year these include a discussion of fungus diseases, the problem of public relations of the physician, and a symposium on psoriasis. The great value of the scientific exhibits in medical education is acknowledged by all. To see exhibits of high teaching value or those dealing with the progress of fundamental research in dermatology and to be able to discuss the subject matter presented with the actual personnel concerned is a rare privilege of the members. The exhibits dealing with the historical and cultural aspects of our specialty are always of great merit and are of value to everyone. The Director of Technical Exhibits with his assistant has arranged for a most important part of our meeting. These technical exhibits have a special appeal in that they are designed to display and present factual information regarding commercial products that we use and that merit your consideration. To implement this program, your duly elected officers with their appropriate committees have chosen a distinguished faculty of approximately 200 dermatologists and scientists in allied fields. Their knowledge, experience, and advice belong to those of you who attend this meeting. These men have worked long and arduously throughout the year in preparing their presentations. Another major reason for the great and continued success of our Academy is the fact that it is a group in which every member feels that he is an integral part of the organization. It is an organization to which we all give allegiance and support by attendance, by participation, by advice, and by well-considered constructive criticism. It is your Academy and its officers and committees are your representatives. As such they are cognizant of and responsive to your needs and suggestions. The program is flexible and changes from year to year to meet the demands and needs of its members.

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The various committees have been extremely active throughout the year. The Advisory Committee to the federal Food and Drug Administration was successful in its efforts to ban "across the counter" sale of local preparations containing hydrocortisone. This committee, under the chairmanship of Edward P. Cawley, was aided by several members of-the Academy, notably Clarence Livingood, Stephen Rothman, Leon Goldman, and Harry M. Robinson, Jr. The Committee on Insurance has initiated group practice liability insurance for our members. The culmination of efforts begun by the Committee on Military Affairs 2 years ago and furthered by the efforts of a Special Committee consisting of Drs. Curtis, Livingood, Sulzberger, and the undersigned, will lead to the adoption of "Recommendations of Standards and Minimum Requirements for Dermatologic Institutional Practice." This report deals primarily with postgraduate training in dermatology. It is planned that the Committee on Professional Practices, in addition to advising on the above, will deal with problems concerned in undergraduate dermatology. The Committee on Public Relations has been most active in cooperation with Mr. Warren Pursetl in the management of favorable publicity at the time of the meeting. In addition, exploratory steps are being taken in regard to a motion picture film dealing with dermatology. This film will be suitable for presentation before nurses and interested lay groups, including high school students and women's clubs. The Committee on Education has spent much time, thought, and effort in the preparation of this year's program. The Committee on Membership has been most helpful in screening the applications for membership and in maintaining the high standards of our Academy. In pathology, the Committee has been busy with an-angements for the two basic courses that are presented yearly. In addition, in cooperation with the An'ned Forces Institute of Pathology, the syllabi and slide sets have been brought up to date. Their choice for the Earl D. Osborne Fellow in 1957 to 1958 was Paul Hirsch. The Advisory Committee on Dermatologic Vehicles has actively cooperated with a similar committee tu the Council of Pharmacy and Chemistry of the AMA. Because of widespread interest on both the pmt of the public and all physicians, but particularly dermatologists, in the biologic effects of ionizing radiation, a new Committee on Ionizing Radiations has been authorized and appointed. Another new committee was authorized by the Board of Directors. This Committee's function was to consider financial aid to dermatologists, dermatologic investigators, and graduate students of dermatology in order that they might attend the International Congress in Stockholm in July. After due consideration of all facts, including especially the factors of past services to dermatology and the Academy, and future promise, the following persons were chosen: (I) Lucille K. Georg, Ph.D., (2) George W. Hambrick, Jr., M.D., (3) Allan L, Lorincz, M.D., and (4) William Montagna, Ph,D. The sum allotted each individual was in no case sufficient to defray more than part of the expense involved. The social side of our primarily scientific organization has a definite place in this meeting. The banquet, entertainment, and dancing on Wednesday night are always enjoyable. The Hospitality Room for the wives of our members is graciously hosted by the wives of Chicago dermatologists. Luncheons with entertainment, a sight-seeing tour with visit to the Museum of Science and Industry, and the opportunity to attend a theatre matinee are a part of the activities for the ladies. The various Alumni meetings on Monday night enable one to renew old friendships and make new ones. Foreign dermatologists are always present at our meetings as guests. It is a wonderful opportunity to meet such colleagues and make them feel welcome. The annual dues of the Academy remained fixed at $I0.00 per year from its founding in 1938 until 1947, when they were increased to $15.00. [t is doubtful if there is any other organization--medical or otherwise-that has not increased its dues in the past 10 years. Just how much longer this state of affairs can continue is problematic. As of the moment, however, the financial status of your Academy is excellent, I have spent a busy but pleasant year serving as your President. To what degree I have succeeded in the performance of my duties, I must leave to others. I assure you that whatever has been accomplished has been due entirely to the unselfish and tireless devotion of out' Secretary, Dr. James R. Webster, ably assisted by Dr. Robert R. Kierland and Mrs. Gerry Feeney. Once again our colleagues in Chicago are our kind hosts. To them our sincere thanks. On to Chicago, the Windy City, with its most understanding, friendly, and hospitable dermatologic confreres. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

Volume 18 Number 4, Part 2 April 1988

This year, 1958, marks the twentieth birthday of the Academy, and on such an anniversary it seems fitting to ruminate on its origin and upon the attributes that make it unique among dermatologic organizations. This mature and ordered body that we take so much for granted did not, like Athena, spring full grown from its father's brow. Instead, the advent of the Academy like that of any human child, was preceded by its conception and then later by the painful and laborious process of organization. More fortunate than many children, the Academy was a much wanted child who had as parents a group of men who had no selfish interest in their creation and from its infancy, it was clear that these men had fathered an offspring whose intrinsic qualities were such that it was destined for success. Of the original group of the Academy's fathers, few are left, but through the years, their infant has been nurtured and cared for by a handful of devoted foster fathers. Like wise fathers, these men have shaped and moulded the character of their child into a pattern that would best serve the interests of its followers. Never dictatorial nor autocratic in their discipline but firmly and with elasticity, they have guided the Academy so that it has come to be the democratic leader of dermatologic teaching today. Through the death in February of Dr. James R. Webster, the Academy lost one of her most devoted foster t'athers. In his conduct of her affairs over the past 10 years, he has served her tirelessly and faithfully. Dedicated to the specialty of dermatology, and particularly to the Academy as an instrument for the promotion of dermatologic education, he knew intimately the function and interrelationship of all her vital parts. When, in accordance with the bylaws, it became my sad duty to succeed Jim Webster as President of the Academy, the ground work for this meeting had already been laid. Procrastination was so foreign to his nature that committee appointmerits had been made and the machinery for the presentation of the 1958 Academy meeting was well in motion. The Academy will mourn Jim Webster, but her loss will not alter the course of her life. Under the guardianship of the kind of men who compose her committees, especially that on Education headed by Dr. Osborne, and of those who so ably and untiringly fill the posts of Secretary and Assistant Secretary, as have Dr. Kierland and Dr. Huff, the Academy's heritage will be safe and her structure will endure. Your Board of Directors has designated the Sunday afternoon lecture by Dr. G. A. Grant Peterkin as the first of the James R. Webster Memorial Lectures and urges you to attend. (Photographs courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

Presidential messages

James R. Webster, M.D. President, 1958

Everett R. Seale, M . D . President, 1958

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The officers invite and welcome each and every member to attend the 1959 meeting of the Academy. The Academy was founded in 1938, and it is befitting that on its twenty-first anniversary, the dermatologic show should be bigger and better. However, a brief perusal of the activities of the academy indicates that each year many new thoughts and progress in dermatology are presented both by the scientific program participants and by the exhibitors. All of you are familiar with the fact that the efficacy of griseofulvin in the treatment of fungous diseases was first presented last year at the academy meeting. So this year too there will be something new to add to our ever expanding knowledge of cutaneous medicine. The total membership of the Academy is well over 2000 and it is not too optimistic to expect an attendance of 1500 this year. The Academy is no longer American in scope, but worldwide. Among its members are dermatologists from Europe, Australia, and North and South America; and guest speakers have c o m e from various parts of the world, including Asia. In Anthony C. Cipollaro, M.D. a sense, the Academy meeting is an annual international gathPresident, 1959 ering of dermatologists that allows ample opportunity for the discussion of dermatologic problems characteristically found in various regions of the earth. This international phase of the academy has been growing rapidly since the policy to admit to membership dermatologists from all regions of the world was inaugurated a little more than 5 years ago. The meeting of the American Academy of Dermatology and Syphilology is the most popular and the best attended meeting of all dermatologic meetings. This enviable record is due to the excellence of the scientific program, method of presentation of new knowledge, and caliber of the physicians participating. The meetings are of tremendous value to all who attend, whether observers or participants. In a sense, the academy is a forum where new knowledge is exchanged among students, teachers, investigators, and practitioners. The meetings are so designed that all those interested in dermatology may become participants. 1 hope that the time is not too far distant when the Academy shall serve internists, general practitioners, and other nondermatologists by arranging and designing a free l-day program to fit their particular needs. It is regrettable that many practicing physicians are so poorly informed in matters pertaining to cutaneous medicine and that the teaching of dermatology is so sadly overlooked in our undergraduate, graduate, and residency programs. Better knowledge on the part of nondermatologists regarding dermatotogic problems improves public relations within the medical family and with the public at large. Again, I think it is worth emphasizing that no single institution offering graduate instruction in dermatology can offer as varied and comprehensive instruction as is available at the Academy meeting, which has at its disposal the voluntary services of leading dermatologists and dermatologic investigators of the United States. This instruction is o f inestimable value and has already served to elevate the standards of American dermatology to a degree unattainabIe elsewhere. The finances of the Academy are sound. I am sure that all realize that the income from the technical exhibitors makes it possible for your officers to keep the dues as low as they are. Friends of the Academy have made donations from time to time to meet special and unusual expenses. This year the Academy was the recipient of two generous donations that will be used for "Educational Purposes" at the discretion of the Committee on Education. To these donors, the members of the Academy join me in extending our gratitude. We are grateful to the founding fathers of the Academy for their wisdom and vision in laying the foundation of a great educational institution. Each and every member of the Academy has done his share in maintaining high standards. America n dermatology has been fortunate in having among its members selfless and indefatigable workers who have served the Academy as teachers, committee members, and officers. We owe a tremendous debt of gratitude to the Committee on Education for the excellent scientific programs it has formulated each year. Dr. Earl Osborne, the Chairman of the Committee on Education, has the admiration of all for his intelligent and effective direction of the committee and for his devotion to the Academy since its inception. I want to express my appreciation to the members of all committees for their willingness to cooperate and serve the Academy. I want to thank too the participants of all programs, scientific exhibitors, and especially dermatologists in and around Chicago for their willingness to act as hosts year in and year out. And finally, my thanks go to all those who were not specifically mentioned, and especially to the technical exhibitors.

Volume 18 Number 4, Part 2 April 1988

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All organizations have a few active members to direct their activities. It is also true of the American Academy of Dermatology. We are fortunate, indeed, in having Dr, Robert Kierland as our Secretary. He is the epitome of punctuality, preciseness, and efficiency. He is thoroughly familiar with every phase of all the activities of the academy and he can recall the slightest detail without referring to his notes. What is more important he carries out his arduous and trying duties with a cheerfulness and a smile that is ever present. I am particularly grateful to him for he has assumed all the burdens of the President and left to me only the pleasures of the office. I also want to thank Dr. Stanley Huff, the Assistant Secretary, and Mrs. Gerry Feeney for alt their help and the many kindnesses they extended to me. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

A review of all the past presidential greetings shows considerable uniformity--brevity in historical comments, enumeration of changes in program and future plans, and a few remarks on fiscal and administrative progress. There seems seldom to be reason for any considerable departure from this pattern. It is 24 years since Howard Fox made public the concept of an Academy (1936). Of the founding committee (1937) six are now alive and active and of the first Board of Directors (1938) nine of 15 membc:rs are still alive and active. Thus the Academy has reached maturity but not senescence; growth and progress continue. At the First Annual Meeting there were two scientific sessions held simultaneously, a pattern expanded today to four. The subjects considered in 1938 maintain their interest to us, with only some deemphasis of leprosy and syphilis and with sulfonamide chemotherapy modified to include the antibiotic drugs. The 2 days of the first program had four symposia, clinical presentations (discontinued after 1948 because of inFrancis W. Lynch, M.D. ability to accommodate this type of teaching to a rapidly enPresident, 1960 larging membership), and group discussions with preannounced subjects, the type toward which there is a return in the past several years. As early as 1941, there was a 4-day program in addition to the courses, the dermatopathologic round table, and scientific exhibits. It is interesting that by 1947 the President, Oliver, pointed out that "the annual meetings shall be held in Chicago until such time as better facilities become available elsewhere." As yet any move has been impractical. The number of participating faculty has increased tremendously, from 19 persons in 1938 to more than 200 in recent years; the attendance similarly has grown to 1355 physicians registered in 1959. While reviewing the annual lists of individual faculty members and because one is writing these greetings in April, one uses the privilege of selecting similes from gardening. Throughout the years a series of varied, interesting, and entertaining "annuals" have been the invited special lecturers on a wide variety of subjects: some of general social significance, others on genera/science, or of genera/medical or dermatologic importance. Many of our members have been observed occasionally as recurring annuals. Our perennials have been numerous, some hardy i n d e e d - - a number of them showing only slight variations but generally maintaining the coloring and patterns they presented initially in 1938: Michelson (Tuberculosis), Finnerud and Cipollaro (Cancer and Prc-Cancer), Lewis (Dermatomycosis), and Brunsting (Porphyria). "Hedging" for the entire garden has been adequately provided by politically minded directors. Our whole garden has been shaded and protected by those strong and solid hardwoods, a series of unusually capable secretaries, whose close continuity was emphasized by the fact that all four were enumerated in the Program for 1954: Osborne as author of the obituary for Rausehkolb, who was then succeeded by Webster, Ibr whom Kierland was that year named as Assistant. No particular plan but a considerable degree of timeliness is evident in the subjects that have been covered in the general sessions of the opening days, leading one to appreciate the breadth and the depth of American dermatology: there have been reviews of normal and abnormal physiology and biochemistry, systemic disorders

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with cutaneous manifestations, cutaneous diseases with systemic accompaniments, diatheses, specific dermatoses, chemotherapy, radiotherapy, and current hormonal therapy. How interesting it would be if one could know even the titles of those sessions to be held in the next 20 years! The current president's name has occurred regularly in the programs, with participation through the years in most of the types of activity of the Academy. In addition to listening and learning he has been a lecturer, chairman, or participant in symposia, on panels, in courses, at clinical presentations and in discussion groups, in committees, as a director, and as vice-president; in 1960 he occupies that position which offers an opportunity to serve all rather than smaller groups in the Academy. He sincerely appreciates your confidence in electing him as President and he has enjoyed both the duties and honors of the position. Familiar by contact with most of the activities of the Academy I wish to emphasize to those whose experience has largely been concerned with the instructional functions of the Academy, the sincere and devoted acceptance of responsibilities and obligations, evidenced by your elected leaders and particularly those who serve arduously as Directors and on the Education Committee. Through the years, these, along with the Secretary and his assistants, are the backbone of the organization and the guarantors of our continued growth, increasingly effective teaching and an expanding influence of the Academy on American medicine. It is my wish that increasing numbers of members may become more active participants in all the varied activities of the organization, although even the most active members must agree that many of the best fruits of membership grow from the friendly and informal association with one's peers and the natural and rather effortless acquisition of practical knowledge, during informal contacts at the meetings. As new terms have been developed to describe the patterns of general pedagogic activity, it is interesting to observe a new emphasis on "horizontal" versus "vertical" education. The American Academy of Dermatology and Syphilology, possibly as clearly as any organization, illustrates the pattern of horizontal education: a program directed by cooperation more than by individual dominant leadership, self-education principally by our own members with only a minimum of participation by outsiders, utilization in the teaching program of members of all ages and many stages of dermatologic learning, and the annual receptive participation by a considerable majority of the total individual members of the society. Such an organization must almost certainly have success in meeting the current needs of its members. With continuation of effective foresight and planning on the part of the Education Committee this will be no static organization but rather one both able and effective in maintaining American dermatology in a position of leadership while dermatology in general grows increasingly important throughout the world of medicine in general. May each of us enjoy the greatest possible benefits from our Nineteenth Annual Meeting and let us all give wholehearted support to those who will lead the Academy in 1961 and in the future. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

It is with deep regret that the officers of the American Academy of Dermatology and Syphilology record the death of Dr. Earl D. Osborne, one of the founders and the most active member in the organization. All who have participated in arty manner in the affairs of the Academy have recognized Dr. Osborne's deep faith in American dermatology and his utmost sincerity of purpose in advancing its standards and clinical effectiveness. He was well known for his strength of conviction as to the aims of the Academy, his determination in the selection of methods to be used, his willingness to serve generously in any manner, and his vigor in the conduct of the affairs of the organization. Not all men have had the satisfaction of receiving the public recognition that they have earned, Dr. Osborne's efforts have been complimented by the members of the Academy in many ways--by elections to the Board of Directors and as President, by appointment to the long periods of service on the most important Education Committee, whose chairman he was for many years--and, uniquely, in appreciation for his untiring and effective services, recognized by the establishment of the Earl D. Osborne Fellowship in Histopathology in 1949. "lhe officers of the Academy of Dermatology and Syphilology again publicly acknowledge the debt owed by this organization to Dr. Osborne and extend the sympathy of all its members to his widow Emily, his son Earl Jr., his sister, and his many close friends and associates, all of whom will so greatly miss his sincere dynamic presence and friendly companionship. Francis W. Lynch, M.D. C. Ferd Lehmann, M.D. Robert R. Kierland, M.D.

Volume 18 Number 4, Part 2 April 1988

Presidential messages

This the Twentieth Annual Meeting of the American Academy of Dermatology and Syphilology, is the fourteenth consecutive meeting to be held in Chicago. The Academy was founded in 1938 to foster postgraduate education in our field of special interest. It has grown in stature and potential as an educational organization largely as the result of the efforts and contributions of its members. Many have given their time, knowledge, and energy to advance the professional skill and training of all of the members of this organization. Each succeeding year has brought increased attendance and greater participation from its members, and in recent years it has attracted dermatologists from all the American states and from many distant countries. We invite them all to join with us in our studies and scientific efforts, and we hope they will find it possible to return from year to year. The primary objective of our organization is educational, and our programs are designed to cover all of the spheres of interest within our specialty and to give its members an opWiley M. Sams, M.D. portunity to become acquainted with the work that is being President, 1961 done in the various fields of basic science that are related to the problems that face us in diagnosis and management of cutaneous disease. The founding members of this organization were, with few exceptions, practicing specialists in our chosen field, outstanding men in their various communities--men who were willing to devote a considerable part of their time to teaching and to the care of patients in the institutions with which they were associated. The men who founded our specialty in this country were all practicing physicians who elected to limit their work to become more proficient and skillful in the diagnosis and management of various disorders of the skin. Independent or successful physicians gave an increasing part of their time to institutional work and teaching. Socioeconomic factors are bringing changes with increasing rapidity. Many of our members now hold full time investigative or professorial appointments. Some of them do no clinical work; many of them limit their clinial work to devote a greater amount of time to administrative or investigative work for the various institutions with which they are associated. The opportunity to improve the image of dermatology was never better than that which exists today. With a full-time representative in our hospitals and schools, the dermatologist will have an opportunity to participate to a greater extent in clinical management and investigative work. The trend in the development of industrial, insurance, and governmental care for increasing segments of our population will create problems and changes in the care and treatment of patients by the practicing physician. It should be the goal of every dermatologist to acquaint himself with the problems that will develop in his community, for these will take place at the community and the state level. Each physician must redouble his efforts to earn and retain his community position in the face of change that will tend to standardize, proscribe, and limit his efforts as an individual. As the Academy has grown in numbers and influence, its educational program has increased in complexity, and we have found it necessary to call on many teachers not only from our own group but from related fields. I wish to take this opportunity to thank each and every one of the participants on the various programs that will be given this year. I wish to thank the men who work so diligently as exhibitors in the scientific field, and I wish to acknowlege the assistance and contributions that are made from year to year by our commercial exhibitors. Many of them are as constant and regular in their attendance as any member of the Academy and we would miss them if they failed to appear. Some have made specific contributions to assist students financially in attending and participating in the various courses that are offered, The officers and the entire membership of the Academy are grateful to them for their contributions.

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As President, I wish to thank our congenial Secretary, Dr. Robert Kierland, and his efficient assistants, Dr. Stanley Huff and Mrs. Gerry Feeney, for the cheerful and efficient manner in which they handle the various problems that present themselves. A multitude of details have been cleared and dissolved with what appears to be no effort, but that is only because the work does not show on the surface. I know from experience that work is involved. For the officers of the organization and for the membership, let me express the appreciation which we hold for our colleagues in Chicago. Each year they seem to make an added effort, and Chicago remains the most feasible location for our annual meeting. [ will look forward to seeing all of you at the meeting this year. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

With this Twenty-first Annual Meeting (ignoring for the moment those wartime years during which no reunions could be held), it may be said that the American Academy of Dermatology has legally come of age. Although [ was not yet a member in its infimcy, I am the proud possessor of a complete file o f the programs, the first issues having been most gratefulIy received fl'om Jim Webster's treasured mementos. [ have not only continued to treasure them as I am sure he knew I would, bul I have read and reread, and studied them, trying to discover all possible clues to explain the fantastic growth and success of this organization. The first program for the St. Louis meeting in 1938 contained only six pages for the entire scientific program, This latter portion grew to 13 for the second session in Philadelphia, 19 for Chicago's number three; 25 for the New York fourth, and the same spread for the first postwar reunion in Cleveland after a meetingless lapse of 4 years. Then the bandwagon truly began to roll, reflected by the everincreasing "poundage" of the program to a high point of about J. Walter Wilson, M.D. t60 pages in 1954, an edition that was soon recognized as being President, 1962 a little too "obese" for comfortable pocketing. At this point (at a somewhat earlier age than the average human being), the book ended its adolescent quantitative growth and began to concentrate on maturing. Several streamlining procedures, such as wasting ahnost no space in page margins and the use of a more compact type and format in general, has reduced the thickness somewhat each year in spite of an ever expanding scientific program. I have at hand attendance totals for most of the meetings, and it appears that without exception every year has witnessed an increase, not only in the total attendance (as was to be expected with the invariable growth in membership) but in the percentage of members actually p,'esent for the annual session. Last December out of a membership of about 2300, no less than 1550 were present, practically an astounding two thirds! I have never heard of any other nationwide organization that can boast consistently of such a degree of adherence. It is against human nature to ascribe this to loyalty or to a sense of duty; it can be explained only by the conclusion that most of the members truly like to attend regularly, and find themselves aware after each reunion that a full measure of value has been received. That these benefits consist predominantly of opportunities for education and reeducation in every phase of dermatology each year has long been amply evident, and it is obvious that this represents in the highest degree the achievement of a primary goal, for such was always the aim of this organization's founders, and equally zealously fostered by all succeeding officers, directors, and committee members. However, although the days of the meeting are all thoroughly filled with study, as well as most of the evenings, there are ample opportunities for enjoyment--short chats with many old friends interspersed now and then, special reunions with old classmates, even at times certain sounds that vaguely resemble music. An entirely "speechless" banquet, with good fellowship and good entertainment followed sometimes by what has been called the "afterglow" seems to set the stage for the final day when the crowd steadily dwindles after noon as goodbyes are said for another year, so that by early evening a poor human being with pruritus could not find anyone to help him in the entire hotel.

Volume 18 Number 4, Part 2 April 1988

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I cannot resist appending some personal remarks. Having discovered very early in life that I possessed no muscles of which I could ever be athletically proud except the small kind that motivates fingers or the tongue, I have always been an "organization man." Beginning at the age of 9, when t helped organize and was the first secretary of the "Grand Avenue Tree House and Cave Society," through Scouts, debating clubs, fraternities, instrumental and vocal musical groups, lodges, 10 years in a service club, and then a long succession of medical organizations, I have always been willing to work for their advancement in any capacity in which anyone thought I could serve, and I have always been happy when thus employed. It therefore did not surprise me, or anyone who knows me, to find me working even more enthusiastically each year for the American Academy of Dermatology, for here is the largest, the finest, and the most intricately perfected organization mechanically to which it has ever been my privilege to belong, and I love it dearly. Having observed that in most organizations only a small group ever volunteers to take on responsibilities, it never ceases to astound me that literally hundreds of our members are willing to work strenuously year after year, with little more reward than the personal satisfaction of a job well done. Paraphrasing Churchill, never have so many done so much for so long for so little return. We owe so much more to them than we can ever pay, that I suggest that a word of appreciation now and then from each of us would be very appropriate. The various Committees and their Chairmen, the Board of Directors, the Scientific Exhibitors, and the Technical Exhibitors all function like a well-oiled machine, rarely emitting even a squeak. Our Chicago colleagues have not only borne with us yearly since 1947, but have actually welcomed us, an attitude far beyond the call of duty. It is entirely beyond my comprehension how any organizations can find such perfect Secretaries throughout the years. Earl Osborne, John Rauschkolb, Jim Webster, and now Bob Kierland (finishing his 5-year chore this year) have set our standards so high as to appear to defy improvement, but I am confident that Stanley Huff will find some way to keep up the wonderful trend. Mrs. Gerry Feeney is truly a jewel as the Secretary's secretary, and has promised to continue in that capacity. The opportunity of being your President this year has caused my cup of gratitude to overflow many times, tempered by only one sad thought--that there are many others who have worked equally (or even more) diligently, and some for longer than I, who have not yet been so honored. One of these was Dr. Herbert Rattner, who was actually slated to be vigorously recommended to be President for 1963 by an interim action of the Board of Directors, and it is comforting to know that he was most pleasantly aware of this plan before his untimely death. To all others in the hard-working category mentioned above, I can only offer as my excuse for my preceding them to this position, that it has long been known that there is no combination of science, ability, talent, devotion, zeal, and political acumen that can always be retied on to beat pure luck. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

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The honor of being President of this Academy is always appreciated and is a source of great pride. Such is my situation--25 years after its first President, Howard Fox, in 1_938. The story of the Academy's growth and excellence in these intervening years has been told well in previous Presidential Messages and by Dr. Samuel J. Zakon, our dedicated and diligent Historian. It would be superfluous for me to repeat this story. Yet, it does seem appropriate to recount some of the answers to questions frequently asked by the members. The answers are in reality my answers (at least no one else should be held responsible for them); however, they are, I believe, a true summation of many hours o f discussion by the Board of Directors, and the Committee on Education. First of all, why Chicago and why in December? The answer to this is not difficult but is long. Since we are primarily and solely an educational organization and exist for that purpose only, we wish the members to attend our annual sessions. Any R o b e r t R. Kierland, M . D . other time of the year would necessarily compete with other President, 1963 excellent meetings (such as the SID and A M A in late spring or early summer, the Southern Medical in early fall, and in the late winter or early spring smaller but important meetings of national extent; all of these and yet saying nothing of the frequent local or regional society meetings). In addition, there are not the distracting influences at this time of y e a r - - n o golf, swimming, or fishing; we come for knowledge and to become aware of the recent developments in our specialty. This perhaps answers "why December." But why Chicago? There are three basic reasons: (1) It is centrally located; (2) it has the facilities; mad (3) most important, there are a willing and dedicated group of Chicago dermatologists who with their wives do cheerfully and well and more, all that is asked of them. Relatively few of the membership are aware of the many prior hours of tedious work that help to make our annual meetings successful. A few years ago I was asked to contact other hotels in other cities concerning this matter, which task I undertook, and quickly the conclusion was reached that: (1) the local dermatologists had no interest in the undertaking of the necessary preliminary tasks and (2) the facilities o f the hotet and of"nearby" medical schools were woefulIy inadequate to construct, obtain, and carry out the format and equipment necessary for our cun'ent type of program. The above statements are in no way to be considered critical of other cities or medical schools--the statements, however, are factual. The Chicago group are to be most highly lauded and complimented for their painstaking work and results. It is needless to mention specific names. This was attempted in my informal acceptance address last December and afterward m y recollection was most embarrassing--far too many deserving individuals were unnamed. Practically the entire roster of the Chicago Dermatological Society should have been included. Thus, my conclusion remains: that as long as wc maintain the high level of education, of teaching facilities, and of aids, the annual meeting should remain in Chicago. This is not to say that improvements cannot be made; these are being made annually, not only in audiovisual aids, but in the caliber of the faculty including nonmembers. All of this costs more money annually; yet it is our pride that our dues remain among the smallest of all national and international organizations. We have been the fortunate recipient of grants from many friends who feel as I do that the Academy is the greatest educational national effort in dermatology. To them we give thanks and our eternal gratitude. Another q u e s t i o n - - H o w may I get on the program? The answer is quite simple. If you have something to offer that is new, current, and factual or even something old but brought up to date, you are welcome on the program. Of course, not everything can be presented each year, but if what you offer is worthwhile, there is an excellent chance. Certain deadlines must be met however. Material for the program must be submitted to the Secretary-Treasurer by June 1 preceding the December meeting. It is suggested then that if you have material to be submitted, one of the following steps be taken: (1) before January 15 preceding the annual meeting, an outline of the proposed subject be sent to the Chairman of the Committee on Education, or (2) if later than this date, the outline be transmitted to the Secretary-Treasurer, who will review the material and send it to the appropriate director or chairman for action. There are limits to the minutes and hours devoted to a subject so material must be submitted early.

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Presidential messages

Two other problems should be considered. The I963 meeting will begin on Saturday, November 30. This is the Thanksgiving weekend, so make your travel reservations early. This will not happen again in the forseeable future but does now. Mark your reservation calendar accordingly. Finally, may i urge your attendance at the Executive sessions, especially the first at which the new Board of Directors is elected. While few are chosen and while comparatively few work for the Academy, this is your organization and the future depends upon you, not on those of us who have served in the past. It is your duty and obligation to voice your opinion in the affairs of the Academy. In recent years it has been my privilege to be your Secretary-Treasurer. As such, I recognize more than most the many individuals who have devoted much to the Academy. They are the individuals who deserve the credit for the success of this great and unique organization--among them have been and are the officers, the members of the Board and committees, the faculty and perhaps most of all Stun Huff, Bob Pommerening, and Gerry Feeney. l am a member of many dermatologic organizations but naturally feel this is the greatest and best of all--may it prosper and continue to dedicate itself for the advancement of dermatology. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

In 1963 the American Academy of Dermatology completed its first quarter century of existence. Those who attended the founding meeting in Detroit and the first formal session in St. Louis the following year glow with pride at the tremendous strides which have been taken. Three hundred dermatologists attended the first meeting and 1631 attended the last. From a 2-day session of formal discussions, the Academy has expanded to a 6-day meeting where, in addition to lectures and papers, many other forms arc employed for the dissemination of knowledge. Courses in histopathology, mycology, microbiology, cutaneous allergy and immunology, physical therapy, and cutaneous surgery are provided by experts proficient in these fields. Motion pictures and other audiovisual aids, group discussions, and private conversations assist members, residents, interns, and medical students in keeping abreast of recent advances in dermatology and allied branches of medicine. In 1963, 22 scientific and 104 technical exhibits completely filled the exhibition hall. The value and importance of scientific Clinton W. Lane, M.D. exhibits were dramatized at the recent meeting of the American President, 1964 Medical Association in June 1964. A telecast originating from the San Francisco General Hospital visualized patients with diseases of the skin. Five of these demonstrations were based in part on scientific exhibits presented recently at the Academy, where each exhibit was a prize winner. Attendance at the annual session is stimulating not only to the young physician but also to those of more advanced age and wider experience. The recent graduate listens to and makes the acquaintance of men about whom he has heard and whose contributions he has read, while the older men are proud to see their younger colleagues, pupils and trainees entering into the activities of the meetings, reading papers, and exhibiting charts and photographs of original investigations and clinical research. Here, too, the rubbing of shoulders, the hearty handshake, the reminiscences, the tales of accomplishment and frustration in practice help the younger physician to realize that efficient, sympathetic treatment of the sick patient is an all important goal. We are proud of the forward advance and progressive studies that dermatology has continued to make in this past quarter century and we look forward to the achievement of many new goals in the coming 25 years. Dermatology has come of age and is recognized as an integral part of medical cmTicula and a vital department of the hospital staff. Except in 1938, 1939, 1941, and 1946, and a 4-year period during World War II, when no meetings were held, the Academy has invaded Chicago for its annual session. The Chicago dermatologists and their wives have labored long and uncomplainingly to produce an effective, pleasant, machine-like operation and they have succeeded well. Many hours and clays of devoted labor and careful planning have been necessary to achieve

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this happy result. However, as in many organizations, the members frequently seek a change of scenery and requests for a meeting elsewhere have become more numerous in the past several years. The chief complaint has been unseasonable weather in Chicago during the month of December. Reacting to these requests, Dr. Stanley Huff, our Secretary, investigated facilities elsewhere, which is a prerogative of his office. The Americana Hotel in Miami Beach, which has played host to the Academies of Pediatrics, Radiology, and Obstetrics and Gynecology was found to be most desirable. Officials of the above societies stated that meetings had been successful and that vacation temptations at this resort had not interfered with attendance at the scientific sessions. The Board of Directors of the Academy was polled and by the large majority of 13 to two voted to change the meeting in 1966 from Chicago to Miami Beach. This is a trial balloon and it is the sincere hope of the Board that the membership witl cooperate with a large attendance and a sincere effort to make this a successful venture. In the past, the Academy has rightfully recognized the sincere loyalty and important contributions of deceased members by naming in their honor the special lectures on Sunday and Tuesday evenings and on Monday morning. This year we are proud to honor four outstanding dermatologists, all former officers and frequent contributors to the program, who have added much prestige to the Academy. They are Stephen Rothman, Maurice Costello, Marcus Caro, and Herbert Rattner. At the meeting in December 1963, a statement of policy was formulated by the Board of Directors, approved by a vote of the membership, and was forwarded to the American Medical Association. It read "The American Academy of Dermatology does not exclude qualified physicians from membership because of race, creed or color." "News," edited by Mr. Stephen Donohue, Public Relations Counsel, has been favorably received and has served as an important, useful medium of information concerning dermatologic investigations and problems. Your officers anticipate and are hopeful that the meeting of 1964 will be the most rewarding and the best attended in history. Success is assured by the continued efficient activities of the Chicago men and women and by the work of all committees, particularly that of the Education Committee. Clocklike arrangements will be guaranteed by the thorough, long labors of our Secretaries, Stanley Huff, Robert Pommerening, and Gerry Feeney, who is really "Miss Academy of Dermatology." When you consider the magnitude of the Academy, the intellectual capacity of its members, the prodigious output of many, it seems almost unlawful that only one person is permitted to serve as the president each year. There have been many brilliant predecessors in this office and the recipient of such a high honor cannot refrain from obtaining a sense of glowing pride and satisfaction but must temper these with feelings of humbleness and awe. To each and every one of you my sincere thanks for your confidence, friendship, and cooperation. May the Academy continue to grow in stature and accomplishments and so assist not only in maintaining, but also in advancing the high level of American dermatology. After a 9-year period of service on the American Board of Dermatology with the privilege of examining and listening to our young physicians I have no fears about the future of dermatology. It is in good hands. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

Volume 18 Number 4, Part 2 April 1988

Presidential messages

On behalf of your office~, it is my pleasure to welcome you to the Twenty-fourth Annual Meeting of the American Academy of Dermatology, This is the nineteenth successive year we have met in Chicago. During this period tota~ attendance has increased steadily, and the percentage of the membership present has grown each year until today the annual sessions of the Academy are the most popular and best attended of all dermatologic meetings. Indeed, they have become international in scope, This is a tribute not only to the excellence of the scientific program and the continued efforts of' the Committee on Education, but also to the precise and painstaking preparations made by our secretariat. It is also a tribute to the dedicated group of Chicago dermatologists and their wives who have worked so long and effectively on the local scene to make each annual meeting a success. In brief, Chicago in December has provided the environment and the facilities that have done so much to promote the educational aims and the growth of our organization. Next year our uncomplaining and longCarl T. Nelson, M.D. laboring colleagues in Chicago will be given a respite when President, 1965 the Academy holds its annual meeting in Miami Beach, In 1967 however, we shall again convene in Chicago. In addition to the wide variety of courses, conferences, exhibits, lectures, and symposia that have become the halhnark of our annual meeting, this year's program includes two half-days of televised clinical presentations. These have been arranged by Dr. Peter Horvath and represent a return to the type of teaching that was discontinued after 1948 when it could no longer be accommodated to our rapidly increasing membership. The Committee on Education anticipates that the televised presentations will prove to be popular and hopes that they may be developed into a regular feature o f the program in the future. In his President's Message of 1953, the late Dr. Michael H. Ebert emphasized that a medical specialty becomes barren unless sustained by an increasing understanding of the basic sciences on which all practice of medicine rests and that only by repeated infusions of new knowledge can the practitioner's interest be revived, his therapy rationalized, and his efficiency increased. A review of this year's program and those of recent years offers ample evidence to explain why the Academy has become such a vital postgraduate teaching institution and why its annual meetings offer such a fruitful opportunity for education and reeducation in all aspects of dermatology. Moreover, as Dr. Louis Brunsting has pointed out on more than one occasion, anyone who has mastered the content of our recent annual programs would certainly qualify for certification by the American Board of Dermatology and would also be regarded as one of the most erudite and knowledgeable of practicing dermatologists. To become such a lively educatkmal institution and to have remained so without developing a hagiocracy or the inflexibility and overorganization that arc signs of approaching senility, the Academy has needed a succession of leaders with vision and energy. In this the Academy has indeed been fortunate for those responsible have repeatedly organized annual programs that offer a maximum of information in a minimum of time. Even more impressive is the fact that this has been accomplished on a fiscally sound basis and a policy of low dues for the membership. This has been made possible in large part by the loyal support of the technical exhibitors, and by the generosity and understanding of certain friends in industry who regularly make donations to the Academy for educational purposes. To these friends of the Academy, all members join in expressing sincere thanks. As President, I am particularly gratefnl to the participants in the various programs and scientific exhibits to be presented this year. Your officers, the Board of Directors, and the Committee on Education believe that this is an excellent program and we hope that it will be the most successful and best attended one yet. The details and various problems involved in arranging a program of this type are many and varied. These have been managed with cheerful efficiency by our Secretary, Dr. Stanley Huff, and his assistants, Dr. Robert Pommerening and Mrs. Gerry Feeney. It is to them that we owe special thanks. They have made my tenure as President a pleasant one. i look forward to seeing you at the meeting of this, the world's best and most successful dermatologic organization. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

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After 19 consecutive and wonderful meetings in Chicago, the twenty-fifth meeting of The American Academy of Dermatology will be held in the spacious and beautiful Americana Hotel in Bal Harbour, Florida. We are happy to welcome you to what we hope will be another successful meeting. The Committee on Education has provided an enlarged and what appears to be an exceptional program. There are some new leaders and new themes. Because of unavoidable circumstances (long-standing previous commitment), the popular colored television programs are omitted. The well-attended informal discussion groups are expanded. This year there is a several-hour interval in the middle of the day to view the exhibits and pursue other attractions. The Committee is considering innovations in material and teaching techniques that will ensure the Academy's preeminence as a force in American postgraduate education in dermatology and that will enable it to continue to serve as a model of organization for other disciplines, in our own, and in foreign countries. Herman Beerman, M.D. The present excellence of the Academy is not a matter of President, 1966 fortuitous circumstance. Unlike Topsy, "I 'spect I growed. Don't think nobody made me," the Academy developed by planned evolution and stands as a monument to the foresight and dedication of a long line of men, beginning with its founders, so well described by Dr. Samuel Zakon in his account of"The Formative Years ( 1938-1956))' the series of devoted and capable secretaries, and the Chicago group, which so gladly and competently shouldered the responsibility for every detail of this prodigious task. Great credit must go to the participants of the program, teachers, and listeners. Study of previous presidential messages reveals a gradual and steady growth in size and coverage of current dermatologic thought. The attendance rose from 283 at the 1st Annual Meeting in 1938 in St. Louis to 1802 at last year's meeting, in Chicago. Membership has risen by steps to the present 2784. The Academy has played a large part in helping this country become the world center of postgraduate education, and has fully earned the epithet, "Greatest Show on Earth," given to it by one of my predecessors and preceptors, Dr. Fred D. Weidman. The Academy was conceived with the idea of affording continuation of training for the increasing number of young dermatologists, especially those not practicing in large centers. It was planned to provide these neophytes with an opportunity for discussion of their problems with more experienced colleagues as well as to keep abreast of the latest developments in dermatology. Our organization has steadfastly kept to this educational philosophy and has met the needs of the younger dermatologists with distinction. Over the years that I have been associated with the Academy, it has been my privilege to observe its workings from the vantage point of a Director, a member of the Committee on Education for 10 years, and now as President. I have been impressed with the discernment with which the officers and committees approached the problems of our specialty. This has led to strong programs. This year's program is no exception. As long ago as 1950, Dr. Earl D. Osborne proposed colored television as a part of our program. There has been increased interest in the basic sciences and in cancer. Interest in syphilis is staging a comeback. Opportunity has been made avaihtble for observing and learning research methods. New surgical techniques have been demonstrated (surgical planing and the like). The Academy has fully assumed its responsibility in presenting the true image of dermatology to the public, medical and lay, through its Committee on Public Relations. The Academy is vitally interested in and endorses the Dermatology Foundation. We urge you to support this organization, which is dedicated to help fulfill the long-range needs and responsibilities of dermatology and seeks to provide help where help is needed. It does not duplicate the work of any other dermatologic group and is the only national nonprofit organization with tax-exemption privileges that solicits and receives funds earmarked for the control of skin diseases through research, improved education, both lay and medical, and better patient care. Although dues have not been raised since 1947, in spite of rising costs and increased expenditures, the finances of the Academy are sound. This is due in no small measure to economics enforced by the Secretariat, to income from commercial exhibits, and to the generosity of our friends. We take this opportunity to thank all who are responsible for this healthy state of our exchequer. Next year the meeting will return to Chicago. While meetings have been previously held elsewhere, St. Louis, Philadelphia, Cleveland, and New York, many of us feel that Chicago is our home and has many

Volume 18 Number 4, Part 2 April 1988

Presidential messages

advantages. Even with certain inevitable and insurmountable shortcomings, we are accustomed to the Palmer House. None the less, it will be necessary to have meetings in other locations periodically. We welcome your suggestions and comments. [ take this oppc~rtunity to express my gratitude publicty to all who have contributed to the success of our meeting; the participants of the program; the scientific exhibitors; and the members. 1 want to thank the officers, the Directors and the Committees for their cooperation in helping to accomplish the objectives of the Academy. I particularly thank the Chicago group, their Florida colleagues, and their ladies. It is they who, in the last analysis, "put on the show." It is wi.th deep feeling that [ single out our Secretary, Dr. Stanley E. Huff, his associate, Dr. Robert A. Pommerening, and the incomparable and devoted Mrs. Gerry Feeney, whose meticulous attention to every detail and whose indulgence of my idiosyncrasies have made the office of President a joy. I also thank the members for their many kindnesscs and expressions of confidence. I hope I shall have the opportunity to greet you all in person in Bal Harbour, Florida. Please come. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

On behalf of your officers and Board of Directors, I welcome you to the Twenty-sixth Annual Meeting, which will be held in Chicago for the twenty-first time. The meetings of our Academy are so large and complex that it is necessary to make plans at least 2 years in advance. The Palmer House will be the site of the 1968 meeting, and in 1969, we will return to Miami Beach, where we had a very successful meeting last year. The members of your Board of Directors will continue to study the question of the sites of future meetings and welcome suggestions from the membership. As noted in previous Presidential Messages, the primary objective of our organization is educational. A wide variety of lectures, courses, symposia, round table discussions, and exhibits have become the hallmark of our Annual Meetings. This year, for the second time, television presentations will be an added feature of the program. The program participants include our own members of all age groups, as well as distinguished physicians and scientists of related disciplines of medicine who Clarence S. Livingood, M.D. are invited as guest speakers. The outstanding programs that President, 1967 are presented year after year, covering all of the spheres of interest within our specialty, have established without question the Academy's leading role in postgraduate education. An increasing number of dermatologists from many countries of the world attend our meetings. In recent years, an important and very desirable trend is that a high percentage of dermatology residents in training attend as guests of the Academy; almost all residents attend at least one meeting during their 3 years of training. I hope that it is appropriate to make some observations about the future of the Academy. Certainly, such a discussion is apt to be more controversial than reviewing the past, but as it has been said by one observer of the passing scene, "We must be interested in the future because that's where we're going to spend the rest of our lives." During the past decade, we have witnessed changes in socioeconomic aspects of health care that may be considered evolutionary, but they represent an evolution that is taking place at a very rapid rate. In addition, we must anticipate and be prepared for new trends in undergraduate and graduate medical education. If one doubts this premise, it is suggested that you read the report of the Citizens Commission on Graduate Medical Education (Millis report) as well as the findings and recommendations of the Willard study. Certainly, all of us will agree emphatically that always, as in the past, postgraduate education must be the primary objective of our Academy, but if we are to meet the challenges that face us now and during the next decade, additional secondat'y objectives should be studied and reevaluated. To a considerable extent, the direction that our specialty takes in the future is in our hands, providing we

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accept the responsibility. The extent of guidance we are able to exercise over that direction will depend on the effectiveness of our efforts in planning and carrying out objectives that are designed to increase the stature of our specialty in all aspects, including research, undergraduate and postgraduate education, and the care of patients. Obviously, the best way to meet the challenge of the future is to continue to provide definite evidence of both our ability and our willingness to perform in our special capacities. During the last decade in particular, the Academy has assumed an ever-increasing role in the affairs of our specialty, which is appropriate, because its membership consists of a very high percentage of the.dermatologists in the United States and Canada, including full-time and part-time investigators, teachers, and those in the various government services. In the strict sense of the word, the American Academy of Dermatology is the one organization that represents all dermatologists. The financial, as well as the organizational support on the part of the Academy, was most important in fostering the Association of University Professors of Dermatology and the Dermatology Foundation. These organizations, each with different spheres of interest, have tremendous potential for influencing the future of our specialty. The Foundation needs and should have the financial support of all dermatologists in this country. In recent years, we have had an active and effective Public Relations program under the competent direction of Mr. Stephen Donohue, supported by the Committee on Public Relations, with outstanding leadership on the part of the Chairman, Dr. Wiley Sams. Another example of a committee that has been assuming an increasing responsibility is the Advisory Committee to Food and Drug Administration under the able direction of Dr. Harry Robinson, Jr. Early this year, Dr. Everett Fox was appointed Chairman of an ad boc Committee of the Board of Directors to study the financial affairs of the Academy. As one would expect of a committee directed by Dr. Fox, already an important recommendation has emerged from its deliberations. It is proposed that the Finance Committee consist of five members, each appointed for 5 years, with a new member each year. If this amendment to the bylaws is approved by the membership, this committee, which will report to the Board of Directors, will have the responsibility of formulating recommendations in regard to long-range planning and commitment of the funds of the Academy. The members of the committee who have studied this problem believe that it is very important to make this change in the structure and responsibilities of the Finance Committee, and I hope that it will have your support. I am pleased to have this opportunity to express my gratitude for the wholehearted cooperation which I have had from our Secretary, Dr. Stanley E. Huff, his associate, Dr. Robert A. Pommerening, and Mrs. Gerry Feeney. It is appropriate to note that Dr. Huff is completing 10 years of service, 5 years as Assistant Secretary and these past 5 years as Secretary. It is a privilege to extend very special thanks to this fine person for his many years of devoted service and to add that we also thank his nice wife. The dedicated manner in which Dr. Pommerening has carried out his assignments as Assistant Secretary makes it evident that he will continue in the great tradition of the Secretaries who preceded him. Our debt of gratitude to Mrs. Feeney increases each year; no one could be more competent or conscientious in carrying out the "thousand and one" details that are involved in the operation of this huge organization, and I know that all of you will be pleased to know that she has promised to continue in that capacity. I am most grateful for the sincere and devoted acceptance of responsibilities on the part of our Vice-President, Dr. Anthony Domonkos, who has a long record of distinguished service in the Academy, and our colleagues on the Board of Directors, and by those who serve on our committees. Indeed, there are hundreds of our members who are willing to work diligently year after year as participants in our program and in all the varied activities of our organization. This is the real strength of our Academy, and with this tradition, one has no fear for the future of our specialty. I deeply appreciate the privilege of serving as your President during this past year, and I thank all of you for your confidence. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

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Presidential messages

This year marks the thirtieth anniversary of the American .....i Academy of Dermatology. The steady increase in membership over the years and the excellent attendance at the annual meeting attests to its popularity and its vital functions and services. The main purpose of the Academy has always been dermatologic education, and it has been a most important forum for the exchange of the latest knowledge between researchers, teachers, practicing dermatologists, and students. It has experimented with techniques in the evaluation of its educational programs. Also, it has pioneered in audiovisual programs and teaching aids. In addition to the courses, symposia, and scientific and technical exhibits with which you are all familiar, there are a number of additional activities to which l would call your attention. The Academy is a member of the National Council on Radiation Protection and Measurements and also has representatives to various organizations including the Council of Academic Societies of the Association of Medical Colleges, MedStanley E. Huff, M.D. ico, the National Society for Medical Research, and the InterPresident, 1968 Specialty Committee of the American Medical Association. Through the Inter-American Affairs Committee, distinguished Latin-American dermatologists and students arc brought to annual meetings for the exchange of ideas and information. The Advisory Committee to the Food and Drag Administration (FDA) serves an important function of liaison between the Academy and the FDA. The Committee on Medical Economics provides a continuous review of the manpower requirements and dermatologic needs of the population as a whole. The Committee on Insurance periodically reviews the various group insurance programs available to the membership. The Committee on Public Relations is striving constantly to present the true value of dermatology to other physicians and the general public. Of course, each of us should continue to do his share to complement these efforts with good citizenship and personaI involvement in community affairs through his church, service organizations, and the Chamber of Commerce. Also, by active membership in, and support of, the American Medical Association and its socioeconomic, educational, and legislative policies each of us will continue to enjoy a close and mutually beneficial relationship. For the information of new members, the Committee on Education meets each January to plan the program for the following annual meeting. Each member should give some thought to the activities of these and the other committees listed in the program. Your constructive ideas are welcome. Because of the size, prestige, and makeup of our organization, more activities are constantly being undertaken to which every member should be alerted. In addition to your attending the scientific portion of the meeting, your attendance and participation in the executive sessions in these times of change and challenge is more important than ever before. The Academy needs the help and advice of all--clinicians, teachers, and researchers alike. Despite personal convictions regarding the propriety of requesting federal aid at a time of increasing deficit financing and grave financial problems, more money is needed by dermatology departments. To this end a Joint Committee on Planning for Dermatology sponsored and funded by the American Academy of Dermatology, the American Dermatological Association, and the Society for Investigative Dermatology has been formed. This committee has been working hard the past few months to provide the Congress, National Institutes of Health, and other governmental agencies with information that hopefully will help establish priorities for federal funds necessary for dermatology in the years ahead. Since the Academy is the largest and most representative organization of all dermatologists, it is logically the best organization to administer any national program that may evolve concerning funds for research and education, and the delivery of dermatotogic care. In requesting and accepting federal funds, however, we must be wary of governmental intervention and regulation and insist that the control of private institutions remains private. We must also stand firm in our basic concept of fee for service for the practicing physician. Historically, clinicians have always contributed generously of their time for teaching medical students and caring for indigent patients. This should continue. The mutual benefit to teacher and student, the efficient use of available manpower, and the financial saving to the school and department ,are obvious. It is also obvious that continuing research and basic science teaching by academicians are equally important.

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I would now like to present some ideas regarding the secretarial office of the Academy. As the size and complexity of the Academy increases it becomes ever more apparent that a permanent and centrally located business office is essential. In addition, I firmly believe our present method of having a new Secretary-Treasurer every 5 years rather than a full-time permanent medical director is the best system to foster fresh new ideas and preserve the vitality of the Academy. These two proposals can be reconciled only by separating the medical and educational functions from the routine business aspects of the office. Not only would the inefficiencies and waste of moving the office every 5 years be eliminated, but the Secretary-Treasurer and Assistant SecretaryTreasurer would be relieved of many routine chores and have much more time to carry out the directives of the Committee on Edttcation and the Board of Directors and to plan the various details that ensure a smooth-running annual meeting. In saying this, I wish in no way to detract from our present secretariat. Having worked with Dr. Robert Pommerening for the past 5 years, [ know him to be highly competent, energetic, and dedicated to the purposes and ideals of the Academy. In Dr. Frederick Kingery he has a most capable and efficient assistant and Mrs. Dorothy Compton promises to be an able secretary to Dr. Pornmerening. I will always remember the unselfish and efficient help of Gerry Feeney. For fifteen years she dedicated her abilities to the Academy. Largely through her efforts and with the help of Dr. Pommerening, the transition in management of the business office has again taken place smoothly. For Gerry the Academy always came lirst and we all owe her an enormous debt of gratitude. Over the years I have enjoyed serving the Academy, but most of all l have enjoyed associating with a great group of dedicated men. I wish to thank the officers, committees, faculties, and members who have aided the Academy with their experience, constructive ideas, and practical help. I particularly would like to thank Dr. Otis Jillson and Dr. Samuel Zakon for their help and advice during the past year. The phrase "all things to all men" perhaps implies a political way of life to some; however, St. Paul's original use of the idea may be applied appropriately to the Academy. There is something of value for each and every dermatologist. I anticipate another fine annual meeting in Chicago, and I am looking forward to seeing all of you. (Photograph courtesy of tt!e American DermatologieaI Association, J. Graham Smith, Jr., M.D., Historian.)

On behalf of your officers and Board of Directors it is a pleasure to welcome you to the Twenty-eighth Annual Meeting of the American Academy of Dermatology. Again the learning experiences offered by our member and guest teachers will be many and varied in subject and in method. Our Academy maintains its excellence in postgraduate and continuing education because of the careful planning and the hard but enthusiastic work of our committees and our membership. Since our Academy involves all as teachers and as learners we help each other excel. A few days after our 1968 annual meeting an unexpected tragedy struck our specialty and our Academy. Dr. Robert A. Pommerening died suddenly on December 17th. Dr. Pommerening had been elected our Secretary-Treasurer at the 1967 annual meeting. Those of us who attended the annual meeting in 1968 saw the results of his leadership. Dr. Huff had already expressed his esteem when he wrote in his president's message, "Having worked with Dr. Pommerening for the past 5 years, Walter C. Lobitz, Jr., M,D. I know him to be highly competent, energetic, and dedicated President, 1969 to the purposes and ideals of the Academy." Too, we know that Bob accomplished much through his enthusiasm, warmth, friendship, and love for his fellowman. He gave much of himself. Dermatology suffered a great loss, when this leader of men left us, but he has enriched the lives of all who were privileged to know him. Our specialty of dermatology has always been more than a group of physicians drawn together by mutual

Volume 18 Number 4, Part 2 April 1988

Presidential messages

scientific interests. We are a cooperative family of intelligent men and women dedicated to help. This was so evident when Dr. Pommerening was abruptly taken from us. There is not enough space in this booklet to tell how so many interrupted their personal activities to be of immediate help so that our Academy could continue its business and progress without delay. The outstanding responses came from our Assistant Secretary, Dr. Frederick A. Jr. Kingery, and Dr. Pommerening's secretary, Mrs. Dorothy Compton. They, with Dr. John M. Shaw who agreed to act as Assistant Secretary-Treasurer during this emergency year, did an unbelievable job. Not a stitch was dropped in our knitting as they moved the office from Seattle to Portland, Oregon, finished 1968, and prepared for January's new committee work. In 1969 it has been business-as-usual with excellence, thanks to these three, to Vice-President Dr. Victor Witten, and to so many of you, your committees, and your directors. American dermatology is indeed fortunate to have such a wealth of willing workers. We are rich in talent. Now I want to talk about the future. But first I must ask you to reread Dr. Livingood's and Dr. H u f f ' s presidential messages in your 1967 and 1968 program booklet. Dr. Livingood introduces the problem of the future very well with his quotation "We must be interested in the future because that's where we're going to spend the rest of our lives." Specifically, I want to talk about the future of the new National Program for Dermatology because some of our members seem to be uncertain about it. This uncertainty is understandable since not all our members were able to attend last year's meetings and not all who did could include the business meetings in their schedules. Nor was the planning committee's ,preliminary report easily available to all. By now we have each received a copy of the final report about the National Program. (If you have not, please ask Mrs. Compton, in the Academy office, to send you one.) We must all study it thoroughly before December. We should have many questions regarding it. Even more important, we should have suggestions for its improvement and a willingness to become personally involved with its implementation. There will be ample opportunity to explore all this in small discussion groups even at our local dermatologic societies in the future. The program will need a multitude of "task-forces" to plan and carry out its work. We must all be willing to offer our specific expertise where it can best be utilized. Let me emphasize again that this program is not a program for or by the government. Nor is it a program for or by only a few in dermatology. It is a program for all in our specialty. Please recall its origin and why it evolved, The public of our nation is concerned with its health and medical care. Its health is the responsibility of its medical profession. Its dermatologic health is the responsibility of our specialty. The membership of American Academy of Dermatology comprises most of these specialists. In 1967, Dr. Shannon, in his penultimate year as Director of the National Institutes of Health, asked if it was possible for any specialty of medicine to plan and guide its own destiny; to plan its future for the improved health of our country. (Certainly, the best defense against outside control is the evidence that physicians can do this.) Our Dr. Philip Anderson, then serving as a Special Assistant to Dr. Shannon, brought this challenge to our Academy. Our president, Dr. Clarence Livingood, accepted the challenge, and, at our 1967 meeting appointed an ad hoc planning committee to explore the question. Under the chairmanship of Dr. Rudolf Baer this committee, helped by several hundred more of our members, went hard to work because a preliminary response was requested to be in print by April 1968. These initial efforts were jointly financed by the American Academy of Dermatology, the American Dermatological Association, and the Society of Investigative Dermatology. Once again, our dermatology family responded. We asked what are we now doing and what should we be doing with patient care, with education, and with disease-oriented and basic research, to help the individual physician give his individual patient the best care now and in the future? Dr. Baer's committee met its first deadline. Its report was enthusiastically accepted as a preliminary one by private, public, and governmental planners for medicine's future. As a result, two things occurred: dermatology, through its Academy, was urged to continue to plan its own destiny, and dermatology was cited as a successful example and as a challenge to other medical and surgical specialties to try to do the same; they too, are responding, it is exciting to see dermatology again among the leaders, patterning the way for improvement. But haven't we always played this responsible role? Recall that the American Dermatological Association, the Archives of Dermatology, the American Board of Dermatology, the American Academy of Dermatology, the Society of Investigative Dermatology and its journal, the Association of Professors of Dermatology, and the Dermatology Foundation--all were among the first of their kind. In the spring of 1968, our president, Dr. Stanley Huff, and his Board of Directors asked Dr. Boer's committee to continue their work. At the 1968 annual meeting the Boer committee presented a more extensive and thorough plan for such a National program to our directors. They and our finance committee agreed with Dr. Huff when he wrote in his pres!dent's message, "Since the Academy is the largest and most representative organization of all dermatologists, it is logically the best organization to administer any national program . . ." Thus, the longterm and continuing planning, evolution, and implementation of our future became the responsibility of the members of the American Academy of Dermatology. It is right that we do plan and finance our own future.

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I urge you to attend all business sessions at our 1969 annual meeting. There we will be told more of the National Program and its progress. Come prepared by having thoroughly studied your copy of the report. Note particularly that this is not a program for a few, but for all. Note that its ultimate goal is to help the practitioner take care of his patient. Know now that the priorities for early implementation are to learn our problems in detail and to correct them with improved education to provide improved patient care. I join all of you in expressing our appreciation to all members and guests who have worked so hard and planned so well to make this 1969 meeting of our Academy the finest postgraduate and continuing educational experience of its kind. We will all come away from it enriched with even more new knowledge that will help us better understand and care for our patients. Particularly, I want to thank our Miami hosts, Dr. Otis F. Jillson and his Committee on Education, our other committees, our directors, and our officers for their willing help, superb efforts, and sound judgment. Too, I thank our benefactors and contributors who help finance these educational meetings, for our dues alone are inadequate to do so. For me it has been an honor and privilege to serve as your President. But you should know that our VicePresident Dr. Victor Witten, along with Dr. Kingery, Dr. Shaw, and Mrs. Compton have made this Academy function not only during my temporary absence, but throughout this entire year. It has been a great pleasure working with such fine, responsible people. I thank them and all of you for the opportunity. Until we meet in Bal Harbour, Florida, in December, my sincere regards to you all. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

On behalf of your Officers and Directors, it is a great pleasure to welcome you to the Twenty-ninth Annual Meeting of the American Academy of Dermatology. The Academy now has more than 3000 members, and the annual meeting has also grown remarkably in size and scope, requiring that plans for the meeting be made several years in advance. The 1971 session will be held again in Chicago and in 1972 we will return to Miami Beach. Your Board of Directors is considering San Francisco for 1973 or 1974. As you would expect, a myriad of details must be worked out whenever we go to a new city, but your officers will keep you informed of future meeting sites as they become known. I think it appropriate in the early part of this message to express my gratitude to our Secretary, Dr. Frederick A. J. Kingery, to Dr. John M. Shaw, Assistant Secretary, and to Mrs. Dorothy P. Compton, Executive Secretary, for their unstinting cooperation and assistance. After the unexpected and untimely death of Dr. Robert A. Pommerening in 1968, these three with Edward P. Cawley, M.D. generous help from many others steered the Academy smoothly President, 1970 through 1969 and into 1970. I also thank Vice-President Hermann Pinkus, the various committees, the Directors, and many of the members, all of whom have given unselfishly of their time and talent. I feel confident in saying that there probably is no other medical group as large as our Academy in which there are so many capable and willing workers. The primary objectives of the Academy continue to be educational, as in the past. As with other worthwhile endeavors, however, education and cducational methods should change when they can be improved. The Committee on Education, under the Chairmanship of Dr. Rudolf L. Baer, has devised several promising innovations for the 1970 program. For example, the Committee has departed from the former custom of designing all symposia and courses to continue for a stipulated period into the future, usually 5 years. Instead, a number have been scheduled for 1970 that probably will not be repeated in 1971. It is hoped that this will eliminate some of the inflexibility from planning for fature courses and symposia. The Committee has also made a determined effort to involve a larger number of active members of the Academy in the annual program. This applies particularly to those colleagues who arc not associated with a teaching institution, and who otherwise might not have an opportunity to participate. In addition, an effort has been made to present more symposia

Volume 18 Number 4, Part 2 April 1988

Presidential m e s s a g e s

and courses that link newer knowledge of basic mechanisms with clinical problems. As an example, the symposium on "Physiology and Biochemistry of the Skin" will be replaced at the 1970 meeting by a session on "Mechanisms of Clinical Disease." Some comments about the National Program for Dermatology (NPD) are probably in order here. Dr. Walter C. Lobitz, Jr., reviewed this topic in his usual clear and concise fashion in the President's Message for the 1969 Program and Dr. Rudolf Baer, Chairman of the original ad hoc Planning Committee for the NPD, discussed certain aspects of it in the December 1969 issue of the Journal of Investigative Dermatology. Without doubt, some facets of the NPD are controversial, but as Dr. Baer said, "The very idea of blue-printing the future of a specialty in a comprehensive plan is such a novel and refreshing one that it is inconceivable that it woukl not stir up a controversy!" Dr. Lobitz pointed out in his Presidential Message "The NPD is not a program for or by the government. Nor is it a program for or by only a few in Dermatology. It is a program tbr all in our specialty." If we are willing to acknowledge that the dermatologic health of this nation is, for the most part, the responsibility of our own specialty, and to recognize that the NPD is unequivocally dedicated to helping meet this responsibility, in addition to helping plan tbr and guide the future destiny of our specialty, I hope that we will support the program. This is not to suggest that criticism be muted, for as with any complex new plan involving many individuals, constructive criticism is both useful and welcome. [ deeply appreciate the honor and privilege of serving as your President during this past year. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

Welcome to the Thirtieth Annual Meeting of the American Academy of Dermatology. Your officers and Board of Directors greet you. Your Committee on Education, with helpful suggestions from many of the Academy's 3400 members, has prepared a program that should be interesting and instructive. You will observe that this year we are offering many more seminars in-depth, additional informal discussion groups, while still retaining the several 2-day intensive courses and the usual stimulating symposia that cover basic sciences, treatment, ofrice procedures, economics of practice, and related subjects appropriate to the proper delivery of health care. It thus becomes obvious that education is the paramount objective of the Academy, as it has been since its inception in I938. A noticeable accomplishment, achieved at our last meeting, is that the American Medical Association's Council on Medical Education has granted full approval for credit of all courses presented at the American Academy of Dermatology meeting. Courses given at the American Academy of Dermatology will be specifically designated as courses offered by an accredited institution and will be so listed in the Journal of the American

J. L a m a r Callaway, M.D. President, 1971

Medical Association. Your Board of Directors, recognizing the impact that national health plans may have on the delivery of health care, has established a Peer Review Committee under the direction of Dr. Morris Waisman to explore what role, if any, the Academy should play in aiding and planning our position in this potential and significant facet of dermatologic practice. The Academy could not function without its committee structure. The Committee on Finance, based on its knowledge of resources available and necessary expenditures, wisely handles the financial affairs for its members. The Committee on International Affairs has done much to increase our friendly relationship not only with our immediate Latin American friends, but has extended its scope of influence all over the world. Your Committee on Public Relations continues to work toward creating a proper professional and public image. Your Vice-President, Dr. Harold N. Cole, Jr., has been a real worker, wearing many hats, working with the Committee on Education, the Board of Directors, and serving this year as in past years as Chariman of the

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Committee on Technical Exhibits. With Board approval he has engaged the services of a professional technical exhibit consulting firm to improve our exhibit format. Other individuals who deserve grateful thanks of the Academy include Dr. Silas E. O'Quinn, Chairman of the Committee on Scientific Exhibits, and Dr. Albert H. Slepyan who works tirelessly as Director of Hotel Scientific Equipment. Few people realize the vast amount of work that goes into the function of your committees on Insurance, Medical Economics, Nomenclature, Advisory Committee to Food and Drug Administration, and the other important, although not individually singled out, committees. For those dedicated persons working in committees and individually who were not spccificially identified please accept the grateful thanks of the membership. Please plan to attend not only the educational programs but also may I respectfully urge the members to attend all of the Executive Sessions of the Academy to speak, to vote, to help your Board of Directors determine the course and future of the Academy. By your expression, your Board can select suitable meeting sites, implement new and innovative program changes, and promote the Academy's excellence in general Our benefactors and contributors who help to finance these meetings above and beyond our dues and fees deserve especial recognition. Belatedly, in this message, comes thanks to the people who really make your Academy the world's greatest dermatologic educational organization. Few people are aware of the untiring and dedicated efforts of your Secretary-Treasurer, Dr. Frederick A. J. Kingery, your Assistant Secretary-Treasurer, Dr. John M. Shaw, and Mrs. Dorothy P. Compton, Executive Secretary. They deserve your accolades and thanks for tasks well done. I wish to acknowledge my personal gratitude to each of them for having made my task simple and pleasurable. To the membership at large may I express my thanks for being allowed the privilege and honor of serving as your President. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

Here it is! The Academy's badge of excellence, the annual program. In it you will find a treasury of distinguished lectures, courses, symposia, seminars, eat and talk sessions, exhibits, panels and grand reunions! It is your guide to gond dermatology and to new vigor in your work. This year, note how the practical is emphasized by the new symposia on itching, on office instrumentation, on cosmetics, on how drags work, and on what your laboratory tests mean. Also, note how the new is constantly brought to you every day, beginning with the research courses on Saturday, and extending throughout Jim Burks' clinic on Sunday to Bob Kierland's climatic What's New on Thursday. Is it any surprise that 2500 of our 3600 members participated in this intellectual feast last year? Plan now to come to Miami and join in the excitement of the best medical meeting in the world. Thanks to your continuing financial, professional, and moral support, the National Program for Dermatology is thriving. We are pleased to announce that on May 1, Mr. Henry C. LongWaiter B. Shelley, M.D. necker became our full-time executive director. Coming from President, 1972 a background of years as an executive in the pharmaceutical industry, he brings to dermatology a wisdom and dedication I know all of you will admire as you begin to know him. The new NPD national headquarters are at Room 2200, 3401 Market Strcet, Philadelphia, PA 19104. Mr. Longnecker will be at our meeting, but for those who do not have a chance to chat with him, please feel free to write him about your ideas, your worries, and your aims for dermatology as a continuing vibrant specialty. We are happy further to announce the appointment of Peyton Weary as the new director and chairman of the Council of the National Program for Dermatology. As the Academy's representative he replaces John Knox who has just completed his 3-year tem~ of office. Again, Dr. Weary's skill and dedication are known and admired by all of you. Remember, he also needs your counsel, support and backing to further mould the National Program in your image.

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Presidential messages

Mere words fail to record the measure of gratitude all of us owe to Jack Knox for the tremendous service he has given dermatology as the first director of our National Program. Sailing an uncharted sea in an open boat, and with weather not always propitious, Jack has brought us all a long way on our journey for "service, education and research." "Captain" Knox we salute you. We would like also proudly to call attention to the election of Rudolf Baer as President of the International Committee for the Fifteenth International Congress to be held in Mexico City in 1977. This is a great doublet of honor for North American dermatology and I know you will give Rudy and our Mexican colleagues the same support you give the Academy. May I ask that you attend the business meeting Monday morning? We solicit your vote on a particularly significant amendment concerning the manner of electing members of your Board of Directors. We also need confirmation of the Board of Directors' recommendation that the annual dues of the society be raised by $20.00. Now I suspect that very few of you read the financial statements of the Academy in detail. Nonetheless, it is important to recognize that the cost of running the meeting is constantly escalating, that pharmaceutical support is diminishing, and that we are now dangerously skirting a marginal level of Academy income. The $20.00 increment is concerned solely with the actual cost of continuing to bring to you the annual program all of us want. It does not represent in any way an increase in financial support for the National Program. Finally, a high light of the Monday morning session will be the bestowing of the first Lila Gruber Memorial Award for Cancer Research. This program you hold in your hands is in general the summation of more than 30 years work beginning with the genius of one of our founding fathers, Earl Osborne, and extending through hundreds of the Academy's illustrious faculty. But in particular this very program reflects the taste and grace of your former president and now the Chairman of your Education Committee, Carl Truman Nelson. Thank you, Carl! Next year Ray Suskind is responsible. Don't forget to write or tell him this December your needs, your accolades, and your gripes. Finally, as President, let me state that my most enviable privilege has been the chance to work closely with John Fromer, Ted Kingery, John Shaw, and Dee Compton. It has been a great year and we all thank you. See you in Miami. (Photograph courtesy of Dr. Shelley.)

Welcome to the Thirty-second Annual Meeting of the American Academy of Dermatology (AAD)! I wish to extend a special welcome to those of you who are attending for the first time. May I suggest a careful review of this program now, well in advance of the meeting, for there may be occasions when you would like to be three or more places at the same time. If you organize now with friends, experiences can be shared later, and your dividends from attending the meeting will be increased. The Education Committee, headed this year by Dr. Ray Suskind, has put together an outstanding program, retaining the best features of the past, and incorporating new innovations in line with current scientific and parascientific events. As an example of the latter, note the special emphasis in this year's program on Peer Review, certainly one of the more timely and dominating events of our bureaucratic times. But more of that later. Presidents are expected to philosophize, for everyone knows they are capable of little else. I wish to use the President's John R. Haseriek, M.D. prerogative to pass on a few thoughts about our specialty; tbr not infrequently I hear questions from residents and even from President, 1973 my peers who wonder about our future. One resident recently expressed fear to me that we will "investigate ourselves out of business." Time has changed very little. I felt the same way many years ago and expressed my concern to my chief, the late, beloved Dr. Henry Michelson, who observed dermatology during a period of perhaps its greatest growth. Dr. Michelson reassured residents with something like, "Dermatology has nothing to fear for it will always have its knowledge which, like gold, is invaluable because of the effort required to get it. Not many

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are willing to spend that time, but those who do will be amply rewarded." As a practicing dermatologist with 4 year's experience in internal medicine, 3 years in a large army general hospital, twice in charge of dermatologic services in two separate Veterans Administration (VA) hospitals, 20 years' experience in a "super-clinic," 3 years full time in a university, and finally in private practice, I may be unique in my exposure to all types of dermatologic care. I am not bragging about this varied experience--friends chide me about being "unable to hold a j o b , " - - b u t it did give me a chance to compare many types of medical care delivery. In effect, ] have lived and worked in the pluristic American system so beautifully reported by Harry Schwartz in his excellent book, The Case for American Medicine. I must agree with Mr. Schwartz that there is something positive to be said for our multifaceted free choice system. There is something good in each type of delivery; but in the final analysis doesn't it really depend upon the patient? We all know patients who much prefer private practice with its one-to-one relationship, with no medical students, interns, or residents between the patient and his doctor. In this situation the patient is the doctor's boss, and both know it and prefer things that way. On the other hand, the super-clinics and the universities offer services that are very special and productive, particularly in their hospital services, and there are hundreds of thousands of patients who prefer this type of medical care delivery to anything else. Surprisingly enough, there are patients who wouldn't and couldn't do without the VA and the service hospitals. Why change a system that offers something for everyone? Politicians are fond of quoting questionable statistics to prove their contention that the United States is at least a twelfth-rate medical power, and, ergo, the government must take over. We all know the weakness of these statistical strategems, but there is one outstanding indicator that is convincing to me of quality medical care: i.e., where do doctors go for postgraduate training? Physicians will do anything and spend money excessively to improve their knowledge. Witness the pilgrimage to Germany in the pre-Hitler days by physicians from all over the world who recognized when they saw it who was leading the medical community. Today, the vast majority of inquisitive medical scientists come to this country to improve themselves, and the AAD docs its share in providing such special knowledge annually as to attract more foreign physicians than any other similar organization. We welcome them and appreciate them. Now a word about Peer Review. Dr. Adolph Rostenberg and his committee alerted us to this problem and asked for the opportunity to present arguments, pro and con, but mainly to educate us. The Education Committee allotted them one-half day, and hopefully adequate space for this important topic. Your attendance is urged, for your future is clearly involved. Not that the members of this organization need Peer Review. The fact that the AAD numbers nearly 4000 strong attests to the hunger of dermatologists for kiaowledge and to their willingness to work to obtain that knowledge. The Peer Reviewers of the future could do worse than to simply credit attendance at the A A D in their evaluation of a dermatologist. The AAD is itself a macrocosm of peer review for it subjects itself to brutal self-criticism regularly. How many of you realize that every single educational event at this meeting is subjected to extensive examination by hard-working, anonymous monitors who rate each speaker, each presentation, each subject according to effectiveness, and educational value? These reports (coupled with your personal evaluations) criticize effectively every presentation at this meeting, and in January 1974, the Education Committee will evaluate constructively all reports, and decide what parts should be deleted, or reinforced and encouraged. I wish to acknowledge my indebtedness to those of you who offered your services so generously during the past year. In particular I wish to express my appreciation to our two remarkable secretaries, Dr. Ted Kingery and Dr. John Shaw, and to Betty Suor, our new executive secretary who undertook the difficult task of replacing Dee Compton, and has done this job smoothly and efficiently. It has been a most enjoyable year, and I thank you for the privilege of serving you. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

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For most the last decade, I have been practically married to the activities of this Academy, and I think it is appropriate to make some comments on its present "state." Here is one man's assessment of where we have come, where we are, and where [ hope we will go. We have come a long way. In 1938 the American dermatologist needed an annual postgraduate assembly. This was provided in spades. In 1968 it became apparent he required more. Dermatologists needed a collective voice to be heard on subjects such as national health insurance, medical liability, peer review, and recertification. The beginnings of such considerations prompted the creation of the National Program for Dermatology (NPD). After 5 occasionally stormy years, the National Program has emerged as an Academy activity addressing itself to these problems and other problems, attempting to anticipate what lies ahead. A tremendous effort is required to overcome the inertia of a basically conservative medical group to institute programs Frederick A. J. Kingery, M.D. that must be undertaken if we are going to maintain our strong President, 1974 position as a specialty. I commend to you a rereading of the editorial in the April Archives of Dermatology by the Council Chairman of the NPD to convince yourself that its objectives are sound. I believe the following list of interests and activities demonstrate that the Academy is an organization that is alive, sparkling, and productive. 1. E d u c a t i o n . The annual meeting is the greatest show on earth. Each year brings a larger attendance. Each year brings innovations from the Education Committee, which carefully weighs many new ideas and balances them against the past format with its established record of excellence. Thus has evolved the small seminars, the forums for fifty, the audiovisual learning resources exhibit, and others. Experimentation without jeopardizing the successful formula is the charge given to the Education Committee. There are Home Study Courses, started in the "think tank" of the NPD and now under the direction of a new committee. The Self-Assessment Test for dermatologists, also an NPD idea, proved overwhelmingly popular, and a second is under way. We are one of many specialties giving such a test. It will be the Academy's responsibility to make available the educational means for the members to correct delicieneies identified by the test, through minicourses, home courses, films, seminars, at the annual meeting. The audiovisual education area is becoming increasingly complex, and this committee will assume responsibility for the content and the excellence of materials produced for the Academy or with its seal of approval. The resources and know-how of the Institute for Dermatologic Education and Communication have been pledged to help the Academy soon. A NPD Task Force for Continuing Education for Dermatologists will continue to explore innovations in education and pass them on as they take shape. To coordinate all of the above, the Board of Directors has established a new special Committee on Educational Affairs. To this group we entrust the effective dovetailing of the many activities and opportunities in continuing education. 2. P S R O . You know that PSRO is the law of the land and that there is much division in American medicine regarding its appropriate implementation. The peer review concept is undoubtedly a desirable and necessary part of medicine today. Medical performance must be evaluated by medical peers. The Academy Peer Review Committee is studying every facet of this complex problem and will recommend a stand for us to the Board of Directors. This stand in turn will be submitted for your support. One would hope that the whole subject of peer review will lose its "police" connotation and become part of the educational process. 3. R e c e r t i f i c a t i o n . The American Board of Dermatology has joined the other specialties in medicine to study the problems of recertification in medicine. Some specialties (medicine, surgery) have concrete plans for reexamination. Some (neurosurgery) have opposed the idea. At the request of the American Board of Dermatology, the Academy Board of Directors has established a comn-fittee to work with the American Board's committee as we search for the answer to the recertification problem in our own specialty.

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4. G o v e r n m e n t m e d i c i n e . We are getting our feet wet in this area--reluctantly at first. An academic society must not "lobby," but yet we must respond to the needs of our colleagues and our patients. We are trying to make ourselves heard as national health insurance becomes a reality, so that patients with disabling cutaneous disease receive the coverage they deserve. We are still naive in the entire legislative area, and our tegislative task force and Washington "listening post" must be strengthened if we are going to maintain our position as a strong specialty. 5. I n t e r a c t i o n w i t h o t h e r s p e c i a l t i e s . As a small specialty whose contact with other parts of medicine sometimes suffers from our sparse exposure to the hospital scene, we must constantly strengthen our lines of communication with the rest of organized medicine, so that our collective voice may be louder than an isolated one. Thus we have representatives now on the Council of Medical Specialty Societies and the AMA Interspecialty Council. We have deIegates to the National Council for Medical Research and the Medical Liability Commission. We support the National Council for Radiation and Measurements. It is the responsibility of the officers to assure the membership that this Academy is represented on every possible medical form. 6. Administration. As the Academy grows, the member's representation must be carefully protected to the end that every Academy action is accountable to the Board of Directors elected by the members. Before you is a bylaws change that will increase the term and effectiveness of the director. These representatives are chosen by you at the annual meeting, and the Nominating Committee is instructed to respond to the voices of special interest groups, regional or otherwise. The Board is an active group addressing itself to all of the problems in dermatology. With the vast proliferation of dermatologic knowledge and activity, it is appropriate that many subspecialty groups have been formed. The Board is charged with preventing this divisiveness inherent in such situations and, therefore, must respond to the particular interests of each group. I hope that each of the subspecialty societies will look on the Academy as a parent organization representing all of dermatology. In this way the Academy can help to fulfill individual needs. You will notice the vast expansion of the committee system to deal with new challenges and with a larger membership. In addition to this committee system, more than 400 Academy members work on task forces within the NPD, purposely loosely structured to provide mobility and freedom at the planning level. Thus, one of every four Academy members participates actively in its affairs. We are becoming too large to work out of temporary quarters. Within a few years 1 hope we will have a peru]anent central office close to those of the other medical specialties. In this way all of the activities l have described can be efficiently handled by a permanent administrative staff. 7. D u e s . Our dues are about average for a specialty society. The army of volunteers and the educational and noneducational programs listed above all deserve your support. Maintenance of activity in all of these areas will probably force the Finance Committee to request a dues increase this year. The frugal handling of funds will continue, and this indeed makes the dues a bargain made possible only by the tremendous volunteer efforts from the membership. So here we are. Welcome to C h i c a g o - - D e c e m b e r 1974. We are a close-knit medical family, and I am pleased to see us handle our minor differences amicably and effectively. In a world where medicine's image is occasionally threatened by those from without, it is good to see the people in this Academy conduct themselves with the dignity and poise expected of physicians. What you see around you should please you very much. You can be proud of the accomplishments of your Academy, and it deserves your support. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

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Welcome to San Francisco and to the Academy's first meeting on the Pacific coast. The growth in our membership and the resulting pronounced increase in the number of those who attend our annual meetings has made it necessary to use two hotels as headquarters this y e a r - - t h e Hilton and the St. Francis. I hope that the outstanding facilities offered by these two hotels will make up for the slight inconveniences which may be caused by this new arrangement. The facilities offered here have enabled your Committee on Education, ably chaired by Ray Noojin, to make signitieant luther improvements in tbe program for our meeting. The year 1974 to 1975 will undoubtedly go down in the annals of the American Academy of Dermatology as a year of major changes and developments which will ultimately be of great signilicance to its membership. Ted Kingery, in his presidential message last year, noted that a whole new "bundle" of tasks had been taken on by the Academy in recent years. This bundle grows steadily larger, and contains many items which Rudolph L. Baer, M . D . must be of profound interest to Academy members. Our ability President, 1975 to deal successfully with these tasks will have an incisive effect on the future of dermatology in this country, insofar as the quality of care, the manner in which this care is delivered, and the intellectual and professional satisfaction derived by physicians who practice our specialty are concerned. After the annual meeting of the Academy in 1974, our capable and dedicated Secretary-Treasurer, John Shaw, brought to the attention of your officers and directors some of the complications attendant on the addition of these many tasks to the traditional educational activities of the Academy. The administrative pressures and the demands on the time of the Secretary-Treasurer now far exceed what can be done by a part-time executive. Your Board of Directors, recognizing this difficult situation and responding to correct it, implemented some important organizational changes. To improve service to the membership a permanent Academy headquarters was established in Chicago. Furthermore, an experienced full-time Executive Director, Mr. Bradford Claxton, was appointed to manage this office and to deal with the day-to-day operations of the Academy. To increase supervisory efficiency, an Executive Committee consisting of the President, Vice-President, President-Elect, Secretary-Treasurer, Assistant Secretary-Treasurer, and Executive Director was created to deal with those items of business that either need not or cannot await the semiannual meeting of the Board of Directors. With increasing involvement of the federal government in all phases of medical education, health care, and health care delivery, your officers and directors deemed it of the utmost importance to keep in close touch with events on the national scene. To achieve this we selected Mr. John T. Grupcnhoff to become "our man in Washington." It is his responsibility to keep your officers and directors informed on all activities and current developments in Washington that might have any bearing on our specialty and be of particular interest to our membership. It is my belief that these innovations will greatly facilitate and enhance the operations of the Academy without altering in any way the basic principle underlying the function of the Board of Directors as the policy-making group. Another step initiated by your directors was to look closely into the general structure of the Academy in the light of developments in the last decade. It stands to reason that in 1936 our founders could hardly have foreseen the many professional, social, economic, and political changes that would unfold in this country some 30 or 40 years later. To cope with these added dimensions, in 1968 thc Academy, with the support of the American Dermatologic Association and the Society for Investigative Dermatology, sponsored the establishment of a National Program for Dermatology. The principal aim of this program was "to conquer disability due to skin disease through patient service, education and research." Under the leadership of John Knox and Peyton Weary, it has admirably fultilled its mission with innovative thinking and planning, and as a result has enabled the specialty of Dermatology in this country to deal effectively with today's new challenges. Now the time has come to incorporate the best features of the National Program for Dermatology into the structure of the Academy. Furthermore, an opportunity to be heard has been created for the diverse segments of dermatology that contribute to making our specialty in the United States such a vibrant one by establishing the Advisory Board of the National Program for Dermatology. All this must bc done in such a manner that fresh

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and experimental approaches will be allowed to continue without diminishing in any way the overall direction by your officers and directors. Effecting much-needed changes without disrupting the smooth running of our established organizational structure has been a real challenge to all of us. However, by applying the same spirit of cooperation and selfless devotion that have characterized the efforts of leaders in Ame,iean Dermatology over the years, regardless of the diversity of their backgrounds and attitudes, I am sure that the difficult task of reorganization will be accomplished in the not-too-distant future. This has been an enormously rewarding year for me personally. I am most thankful to John Shaw and the other members of the Executive Committee, Herbert Mescon. Harry Arnold, and Walter Larsen, and to your Directors with all of whom I have enjoyed the privilege of guiding the affairs of our Academy. (Photograph courtesy of the American Academy of Dennatology, John E. Wolf, Jr., Archivist.)

As a good executive should, your president has spent the year watching approvingly as your new Executive Director and Associate Executive Director have helped Secretary-Treasurcr John Shaw and the chairmen of the new councils organize thcir committees and continue or resume the conduct of the Academy's affairs. This implementation of the Academy's new administrative and executive structure has been the first order of business. The Councils on Scientific Assembly, Education Affairs, Communications, Government Liaison, Administrative Affairs, the National Program for Dermatology, and the Advisory Board Council, all responsible to the Board of Directors, constitute the restructured Academy. Their committees have been appointed and are at work. The Academy's traditional primary concern with education is beirig expanded by the Council on Scientific Assembly under Harry L. Arnold, Jr., M.D. Rees B. Rees into postgraduate and regional courses, in addition President, 1976 to the annual meeting, which is being expanded through additional Seminars-in-Depth and Forums for Fifty-One. The Council on Educational Affairs under John Strauss is actively exploring the problems of self-assessment, home study courses, audiovisual education, continuing competence, and program accreditation. Skee Smith's Council o n Communications is concerned with our publications: the new quarterly informative Bulletin, edited by Tom Jansen, and the monthly informal Schoch Letter for the interchange of pearls and questions; liaison with the health industry; public information; and resource attraction, Peyton Weary of the council on Government Liaison, with our Washington representative John Grupenhoff, has been approaching legislative problems with firmness and finesse, and has achieved several important victories in informing legislators in Congress more tully about proposed lcgislation which might have created serious problems for both the practicing dermatologist and the patient with cutancous disease. Under our Council on Administrative Affairs, chaired by Morris Waisman, the committee on revision of bylaws, chaired by Charles Heaton, has done a splendid job on the difficult, complex task of completely revising and rewriting our bylaws to embody the new administrative structure, and to comply with Minnesota corporation law as well as with modern standards of "due process." They embody the mail ballot for directors and officers, as advocated by the California members at last year's meeting in San Francisco, and are presented for your approval at this meeting. Mark Allen Everett chairs the Council on the National Program for Dermatology, which has as its charge long-range planning and the development of innovative approaches for the solving of complex problems. The National Program for Dermatology consists of committees and task forces on research planning, medical service planning, educational planning, nomenclature, ethics, ionizing radiation, manpower, clinical practice, careers, fellowships, and history. Finally, for maximum interchange among demmtologic organizations, there is the

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Advisory Board, chaired by Charles H. Grecnbaum. There are 132 names in the directory of officers, directors, councils, and committee chairmen. The second major preoccupation of your officers and Board has been the new version of the bylaws; they have been drawn up, revised by your Board of Directors, and approved in final form. Apart from the new structure, and the mail ballot, they change very little. The office of vice president is continued, and it is he, not the president-elect, who will act for, or succeed to office during the term of the president. The immediate past president will, under the new bylaws, be retained for I year as a member of the Board, exofficio. The Nominating Committee will now be elected by the Board of Directors, in staggered 4-year terms. The Secretary-Treasurer and Assistant Secretary-Treasurer, since they must not be chosen on the ground of popularity alone, will still be chosen by the Board of Directors; and the new assistant, to succeed Dr. Larsen, is Dr. Franklin Pass of Minneapolis, We do not know as this is written what limits may be imposed by either federal fiat, or risk of litigation, on our power to prescribe ethical standards: specifically, to prohibit blatant advertising and solicitation of patients. Perhaps by meeting time the issue will have been clarified. Many of you have participated, at considerable cost in terms of effort and curtailment of productivity, in the national dermatologic manpower study. It is hoped that we will have obtained valuable information from this to aid us in increasing residency training in dermatology. In summary, this "state of the Academy" message can be summarized by saying that the Academy has never been so strong, or functioning so vigorously along so many fronts. As I predicted in San Francisco last December, I have had to hurry to keep up with those 1 was elected to lead? Thc real burden of work has been borne by your Executive Director, Bradford Claxton, who has amply fulfilled our expectations; by his assistants, Rob Hamilton and Betty Suor (who has, regrettably, left us to go home to the Pacific Northwest); and perhaps most of all by John Shaw, our Secretary and President-elect. No president of the Academy has ever been able, as I will be at the end of this meeting, to leave the world's largest and most effective dermatologic organization in better health or in better hands? (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

Welcome to the Thirty-sixth Annual Meeting of the American Academy of Dermatology. Chairman, Robert W. Goltz, and the members of the Council on Scientific Assembly have introduced new programs ranging from a television clinic Tuesday night to concentrated "short courses," which present informative reviews of significant material. As you read through the 1977 program, take a moment to reflect on the complexity and organization of the curriculum. The Academy meetings earn the envious approval of the AMA and all our sister organizations. Such a reputation does not "just happen." It is due primarily to our dedicated, outstanding faculty, and to all of them I extend our grateful thanks. Also, I wish to salute the Council on Scientific Assembly--the planners Drs. Goltz, Dobson, Kopf, Sams, Jr., and Jansen. Special thanks are due our Executive Director, Bradford W. Claxton, who has performed so well under the supervision of your Secretary-Treasurer, Waiter G. Larsen and his Assistant Secretary-Treasurer, Franklin Pass. The success of the meeting John M. Shaw, M.D. rests on the shoulders of these hard-working people. They have President, 1977 earned your commendations. Through the direction of Mr. Claxton, with Drs. Larsen and Pass, the annual meeting is coordinated with Dr. John Strauss' Council on Educational Affairs and Dr. Charles Hcaton's Committee on Evaluation. These people constantly seek methods to make the presentation of new information interesting and easy to absorb. Your annual meeting gives you the chance to review basic material, emphasize clinical interests, and expand therapeutic techniques. Every registrant should enjoy maximum benefit from his timc in Dallas.

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This year the Council took full advantage of the Dallas Convention Center and utilized better space for many expanded programs. It is a big center, and all the activities from the Informal Discussion Groups to the main Business Session wilI take place there. I think you wiIl like it. You will not be as pleased with your local hotel accommodations. There are just too many of us, and the growing numbers of registrants forced the office to use several hotels. We cannot escape it--this is the way of the future. To keep the quality of rooms at an acceptable level the Academy had to utilize hotels scattered over Dallas in all directions. The distances will require buses to move you to the Convention Center and back. This is another "first." Bear with us, and please be patient. And now to all members of the Academy I extend my personal thanks to you for your spirit, enthusiasm, and support. It has been a privilege to serve you over the past 9 years. You can look forward to a greater year ahead under the leadership of Rees B. Rees, M.D., and your capable Board of Directors. With this outstanding leadership and administration we will continue to grow and to fulfill an increasingly important position in medicine. Welcome to Dallas. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

Welcome back to San Francisco. This will be our Thirtyseventh Annual Meeting of the "Greatest Show on Earth" (the late Fred Weidman's description, after P. T. Barnum). Inevitable changes due to our rapid growth (the membership has nearly doubled in the past decade) include moving the Monday through Thursday sessions and the exhibits to the Civic Auditorium and Brooks Hall, meaning that busing will be necessary. Breakfast discussion groups will remain in the Hilton and St. Francis Hotels. There will be no luncheon groups on Tuesday and Wednesday, these being replaced by Dermavision, which was so successful last year. Year after year, about two thirds of the members, not including applicants, attend the annual meeting--a fabulous record. Approximately 600 of the members are actively engaged in the operation of the Academy functions. The resolution of the Dermatology Section of the Southern Medical Association gives me the opportunity to offer some comments. This resolution was proposed by John M. Knox, Rees B. Rees, M.D. who headed the now defunct National Program for Dermatology President, 1978 so brilliantly for 3 years. There was objection to pre- and posttesting. It is true that the educationalists cannot tell us whether such efforts are meaningful. But the Council on the Annual National Meeting, headed by Richard Dobson, and the Evaluation Committee, chaired by Charles Heaton, uses these as an added means of improving the program, besides the computerized evaluations made by members. It was voted this year to limit these tests by making them required for the courses and voluntary for the forums and seminars-in-depth. Complaints also have been registered regarding fees to attend forums and seminars-in-depth. An alternative to charging fees is raising dues for everyone. Because some members were unable to gain entrance to some of the more popular forums and seminars indepth, enrollment capabilities have been expanded. It is hoped that next year, with better computer control, those unable to obtain first choices will be given priority in the following year. It is alleged that the Academy stresses quantity rather than quality and tries to do something for everyone. This is tree. In 1968, President Stanley Huff said that the phrase "all things to all men" perhaps implies a political way of life to some; however, St. Paul's original use of the idea may be applied appropriately to the Academy. There is something of value for each and every dermatologist. Courses are now being structured and labeled for different levels of qualification, and alI program items bear descriptions concerning purpose. Complaints about paperwork are being voiced. When the new system for computerization of Academy

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Continuing Medical Education (CME) credits is fully operational, this should be alleviated to some extent. In my own practice, paperwork related to Academy affairs is minuscule compared to other d e m a n d s - - e x c e p t during this presidential year! What about recertification? This is in the realm of the American Board of Dermatology, but there is a new committee composed of seven representatives from the American Board, five from the Academy, plus one each from the professor's association and from the Advisory Board Council of the Academy. We trust they will work out a painless way of responding to the inevitable. Remember that certification is and always has been voluntar'y. Bureaucracy seems to be another topic of concern. As far back as I can remember, the Academy has had salaried individuals. Ten years ago, President Huff stated that ~ the size and complexity of the Academy increases it becomes ever more apparent that a permanent and centrally located business office is essential." Establishment of such an office was accomplished a number of years ago. Our present Executive Director, Bradford Claxton, has been administrator of that office for 4 years. In the words of our exceptionally able and dedicated Secretary-Treasurer, Walter Larsen, the Academy "runs a tight ship." He personally oversees the function of the full-time staff, which faithfully carries out the directives of the Directors. The Directors, democratically elected representatives, are the real operating machines of the Academy. Someone recently told me we are all dancing to the tune of the full-time executive staff. The reverse is true. There has been some unhappiness over Academy-sponsored meetings away from the annual meeting. It is emphasized that these courses are mounted only in response to requests from local organizations or groups. These are hard-working meetings, with dedicated instructors. With regard to CME credits, as of 1978, 22 states have passed enabling laws requiring CME credits (and other qualifications as well) for relicensure. It must be emphasized that the Academy's program is voluntary. There are pathways within the Academy for fulfilling requirements without attending the' Annual Meeting, that is, through the home study courses and the like. This is a service to all of us. Are our actions defensive? Yes and no. The Academy has always been forward looking, and has not achieved a worldwide reputation as the premiere organization for dem~atologic learning merely through the mechanism of defensive reaction. The new direction in CME, which followed the report of the National Advisory Commission on Health Manpower in 1967, was really a manifestation of the government, the third-party payer, seeking to ensure cost justification for the health care it purchased. The Liaison Committee on Continuing Medical Education (LCCME) is one of a triumvirate of committees functioning under the Coordinating Council on Medical Education (CCME). Incidentally, the LCCME is taking over the accreditation programs of the American Medical Association (AMA). The CCME has seven parent organizations: AMA, American Association of Medical Colleges, American Board of Medical Specialty Societies, American Hospital Association, Council of Medical Specialty Societies, the federal government, and the public. We must learn to survive in this morass. Does the Academy dominate local and regional dermatologie organizations? The answer is no. The reverse is true. We members elect the directors, the president, the vice-president and the president elect, and the directors guide the affairs of the Academy and select certain key appointees. The president is the presiding officer, who does not vote except to break a tie. The Advisory Board Council, headed by Marshall Blankenship, provides input to the directors from every dermatologic organization in the United States and Canada. In addition, members have the opportunity to vote individually on issues via the Academy Bulletin. This newsletter gives its readers an opportunity to study the issues, both pro and con. It has been said that the Acadmey is losing its warmth and sensitivity to the needs and wishes of the members. It is difficult to know how to respond to this. Since all of us are the Academy, we could make the effort to be more friendly to one another, and we could go out of our way to be cordial to new members. As we get to know members of the executive staff, they also will become our friends and colleagues. Now, turning to another subject, your directors have voted, with one nay or abstention, to establish a new journal. This was after four successive presidents, including me, had appealed to the AMA to allow the Academy to purchase the Archives of Dermatology. The mail vote of the members, by way of the Academy Bulletin, indicated that this is the wish of the members. This new journal will in no way compete with the Archives or the Journal of Investigative Dermatology, and I urge you to continue to give full support to these journals. Initiating a new journal will necessitate a dues raise of $25, which covers subscription to the new journal. Skee Smith will be the editor. I wish to thank all the more than 600 members who are carrying out the Academy functions, as well as members for your support, and I especially wish to thank the individuals named previously as well as the incoming President, Bob Goltz, who is a giant in every respect; Don Birmingham, the Vice-President; Frank Pass, Assistant Secretary-Treasurer; the Directors; all of the executive staff; and last but not least, John Strauss, Peyton Weary, Herbert Goldschmidt, Marshall Blankenship, and Peter Horvath who have done so very much for all of us.

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This year, the Gold Medal was awarded to Rudolf L. Baer. Honorary memberships were given to Harry L. Arnold, Jr., Stanley Huff, Frederick A. J. Kingery, and John M. Shaw. Food for thought: The Dean at the Universityof Californiaat San Francisco, Julius Krevans, recentlymade this statement: Humanity in Medicine is controlled by a group of angels, and every time someone says "provider" instead of physician or nurse, one of those angels dies; and every time someone says "consumer" instead of patient or person, another angel dies; and when all the angels are dead, there will be no humanity left in medicine. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

This year the Academy returns to hold its annual scientific meeting in its traditional home in Chicago. Membership in this foremost of dermatologic organizations continues to grow; we now number more than 5000. This is healthy, but it does have some unfortunate side effects, one being the problem of accommodating our expanding convention under one roof. We have so far outgrown our former Chicago meeting place that this year we have to utilize two hotels, the Conrad Hilton, as well as the Palmer House. Registration and the technical, scientific, and art exhibits will be based at the Conrad Hilton, while the scientific program, seminars, symposia, and informal discussion groups will be held in both hotels. A shuttle bus service will be available between the two hotels, which fortunately are also within easy walking distance of each other. The Council on the Annual National Meeting, under the energetic chairmanship of A1 Kopf, has put together an outstanding program, enlarged and improved to meet the expanding needs of our growing number of registrants. The Council this Robert W. Goltz, M.D. year has attempted to make access to the various components President~ 1979 of the program even more accessible than it has been in the past. There will be an increase in the number of functions for which no special admission fee will be required. Three entirely new courses will be offered; one on cryosurgery, one on occupational dermatoses, and one on cardiopulmonary resuscitation, a technique in which all physicians should be experts and one increasingly required for hospital staff privileges. It gives me great pleasure to call your attention to the special concert of the Chicago Symphony Orchestra under Henry Mazer, with Agustin Anievas, piano soloist, to be held exclusively for Academy members and their guests at Symphony Hall on the night of Tuesday, December 4th. Sponsorship of this outstanding cultural event is an exciting innovation for the Academy; I hope it will mark the beginning of a continuing tradition. The year of 1978 and 1979 has been marked by a number of significant developments. Foremost among these is the launching of the Academy's own publication, the Journal of the American Academy of Dermatology, under the editorship of J. Graham Smith, Jr., M.D., and the outstanding Board of Editors he has recruited. The JAAD makes available to the Academy its own journal for rapid, in-depth communication with its members, as well as for organized continuing dermatologie education; The success of the JAAD seems assured. Another development of interest this year has been an increasing interest by members of the Academy in active participation in its affairs, through direct approaches to the officers and directors, and through increasing activity of the Advisory Council, lead by Marshall Blankenship. This is all to the good. As the number of members grow it becomes increasingly important to strengthen the channels of communication between the Academy's members and its officers, directors, and staff. In my view, one of the outstanding achievements of the National Program for Dermatology a few years ago was the recruitment of a wide spectrum of dermatologists into active participation in the various activities developed for the benefit of our specialty. Many of these individuals have now graduated to working actively in the affairs of the Academy, serving on its various councils and committees. Now it is time to be recruiting the next generation of dermatologists. This may be a little harder to do now than it was 10 years ago, if only because of the growth in size of the specialty. Perhaps the Advisory Council, with its roots in the local dermatologie

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Presidential messages

societies, can take a leading role in this important task. In addition, any member, young, old or in-between who has an interest in working actively in the affairs of the Academy should come forward, either through his local society's representative on the Advisory Council or directly to the Academy office. The Council on Educational Affairs, under the dedicated leadership of John Strauss, continues to offer Academy members opportunities to meet their accredited continuing medical education requirements in a convenient, economic, and educationally meaningful way near their home. The compilation of CME credits through the Academy computer is a valuable service to those of us living in states that require evidence of participation in continuing medical education for continued membership in medical societies or even licensure to practice medicine. The Educational Affairs Council activities are not sporadic, but require a lot of time and effort throughout the year. The Academy is greatly indebted to John Strauss and the other members of his council and committees for the long hours of hard work they have put in and for the flak they have sometimes had to take. Now John has applied for well-earned retirement from chairmanship of this council. His successor, Marie-Louise Johnson, can be counted on to continue this fine leadership. The activities of the Council on Government Liaison, under Peyton Weary, are of growing importance to the Academy and to the specialty of Dermatology. Demaatology needs to maintain the highest possible visibility, in a time when profound changes in the system of delivery of medical care through government fiat are being proposed. The special needs of our relatively small, non-hospital-based specialty and the patients whom we serve must constantly be made known to those in the seats of political power as these far-reaching changes are discussed and implemented. Pcyton and members of his council, assisted by John Grupenhoff, continue to do an outstanding job in this area. The Council on Long Range Planning, under the Chairmanship of Mark Allen Everett, continues the important function of long range planning for the specialty as a whole as well as for the Academy itself. The Council on Clinical and Laboratory Services, headed by Loren Golitz, continues its multifaceted activities related to the practical matters of day-to-day dermatologic practice. To choose but two examples, the Task Force on Photobiology and Psoriasis continues to monitor the evolving status of PUVA therapy, while the Committee on Pathology is actively engaged in the creation, servicing and distribution of teaching slides in dermatopathology, as well as staging courses. Regretfully, space does not permit giving due recognition to each and every one of the many dermatologists who have served so faithfully and so productively on the many committees and task forces of the Academy this past year. Maybe it is enough to reiterate that without this generous contribution by so many, the Academy simply could not function. This year marks the last year of service as Secretary-Treasurer for Walter Larsen. For the last 6 years Walt has served the Academy devotedly, first as Assistant Secretary-Treasurer and for the last 3 years as SecretaryTreasurer. Walt surpassed the perlbrnmnce of even his distinguished predecessors in this demanding office. I presume to speak for all the members in expressing our gratitude to Walt for his dedicated, patient, intelligent service to the Academy in these past years of rapid growth and development. Walt is to be succeeded by Franklin Pass; we can be assured that under Frank the Academy's affairs in the key office of the Secretary-Treasurer will continue to be in hands in whom we can all be confident. Brad Claxton, Executive Director of the Academy and the able staff he has assembled, continue to carry on the day-to-day business of the Academy in a most effective and efficient manner. We are fortunate to have a man of Mr. Claxton's caliber and dedication serving the growing administrative needs of the Academy. In addition to being an able administrator, Brad is widely recognized as one of the most outstanding individuals among administrative officers of national medical societies. He represents the Academy well, outside of, as well as in-house in our Evanston office. Last but not least, I would like to thank the members of the American Academy of Dermatology for the honor of having been allowed to serve on the first slate of officers elected under the ballot system instituted in 1977. There can be no greater privilege for a North American dermatologist than to be called on to serve as President of the American Academy of Dermatology. It has been a very great honor for me to do so, and I am most grateful to the members for this opportunity to serve the Academy and our specialty in this very special way. In spite of all the uncertainties that confront our specialty, and medicine as a whole, I am confident that the continuing unselfish contribution of its members to improved patient care through the finest in dermatologic education, for themselves as well as for others will cause the Academy to continue to flourish in the decade of the 1980s and beyond. (Photograph courtesy of the American Academy of Dermatology, John E, Wolf, Jr., Archivist.)

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There are numerous innovations in this year's meeting that have been put into effect by the Council on the Annual National Meeting. Under the skiltful dh'ection of Mitch Sams (Chairman of the CounciI), plus the excellent help of your new SecretaryTreasurer, Frank Pass, your new Assistant Secretary-Treasurer, Tom Jansen, and our efficient administrative staff, considerable changes in programming have taken place that should result in the "best meeting yet." The most common complaint we have received from the Academy membership these past few years concerns the charges made for attending certain educational activities at the time of our annual meeting. Specifically, many members complained about paying tuition to attend the forums and seminars-in-depth. After careful consideration of these two educational activities and with help of our evaluation system (prepared by Charlie Greenbaum), the Council decided on the following major changes in your 1980 program: - - S i n c e analysis showed that the difference between a forum and a seminar-in-depth became blurred, both of these Alfred W. Kopf, M.D. educational programs will now be called "forums." ConsePresident, 1980 quently, the category of "seminar-in-depth" has been dropped. - - T o open up more of the program on a non-tuition basis, it is no longer necessary for you to pay a specific fee to attend forums. - - A n a l y s i s has shown that the most popular teaching exercise at tile annual meeting is the informal discussion group. To expand this type of activity within the constraints of the two convention hotels in New York City, a new type of educational program called "round table discussions" has been planned for you in midmorning and midafternoon to accommodate those who cannot attend the breakfast or luncheon informal discussion groups. Otherwise, the round table discussions will be a similar 1 V,_-hour learning experience. - - N i n e new symposia have been added this year and the number of symposia on Saturday and Sunday has been increased. Again, the plan is to broaden the scope of subjects and to incrcase the number o f " f r e e " sessions available throughout the meeting. It is important that you note that this year there are three separate exhibit areas, two for the technical exhibits and one for the scientific exhibit. Please be sure to determine the location of each of these areas so that you do not miss this popular aspect of our meeting. As you know, to accomplish increasing the number of open sessions, it was necessary to charge a general admission fee this year. Many organizations similar to ours have such a fee for those who attend their annual meetings. I personally believe this is a better alternative than a general dues increase to cover the financial loss resulting from increasing the availability of open sessions. In this way, it is those who attend and therefore directly benefit, who shoulder a greater portion o f the cost of putting on the annual meeting. When I took office as President, i outlined the following areas of special emphasis on which I would work during this year: - - T o increase ntember participation in the affairs of the Academy. - - T o take steps to establish permanent headquarters for our administrative functions. - - T o refine the organizational structure and fnnction of our councils, committees, task forces, and consultants. - - T o carefully review expenditures to ensure prudent spending and fiscal responsibilty. - - T o perfect a more coordinated and comprehensive continuing medical education program that will meet the learning and statuatory needs of our members. - - T o promulgate guidelines of ethical conduct for our profession. - - T o explore the possibilities of developing a biomedical communications network for dermatology. - - T o attempt to resolve the numerous logistical problems we currently face with putting on our annual national meetings. - - T o maintain close vigilance of the legislative arena on a national level. - - T o improve communications between the Academy and other dermatologic societies and organizations. I shall briefly address progress that has been made in each of the above areas during the Monday morning business meeting. As you know, last year we lacked a qttorum to conduct business near the end of this session. We have, therefore, reorganized the business meeting this year so that the key issues can be handled nearer the beginning. Also, some competing events such as the Residents' Forum ilave been moved to other time slots and

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the exhibits will not open until I 1:00 AM. This year some very important decisions in the voting anti nominations process will come up for your vote. To be able to conduct business it is mandatory that a quorum be present. Since the items on the agenda are of such great importance to you, I am making this strong plea for all of you to be present at the business session Monday morning. New York City is unexcelled in entertainment and gustatory pleasures. We have attempted to simplify obtaining tickets for those who wish to attend the many good shows in town. As you know, on qSaesday night the New York City Ballet will give a performance of the Nutcracker Suite for the Academy. A total of 1200 seats have been reserved for our members to attend this magnificent display of unexcelled talent. I can assure you that those fortunate enough to obtain tickets will not be disappointed. I invite each and every one of you to send suggestions for improving our annual meetings to our Executive Director, Brad Claxton, who in turn will inform the members serving the Council on the Annual National Meeting. Each suggestion will be given thoughtful consideration. It is indeed remarkable that more than 80% of the dermatologists in the United States who are members of the Academy come to our annual meetings. The Officers, Board of Directors, Councils, and Committees are fully aware of their responsibility to provide for you the best possible continuing medical education program in existence. We have been tops for years--and we intend to stay there! Finally, I would like to take this opportunity to once again thank you for electing me your President. It has been truly the most rewarding and enriching experience of my life. (Photograph courtesy of the American Dermatological Association, J. Graham Smith, Jr., M.D., Historian.)

For those who "left their hearts in San Francisco" at the 1978 meeting of the Academy, we will return to that beloved city and recapture our hearts at a place that holds so much fascination and charm. To hold the annual meeting in San Francisco has always been a great challenge due to the lack of exhibition and meeting room spaces available in a single building. That challenge was again presented to Dr. Richard Odom and his Committee as plans were formulated for this Fortieth Annual Meeting. Moscone Center, San Francisco's new meeting and exhibition center, had been in the planning stage for years and is presently under construction. The Committee on the Annual National Meeting has been assured that Moscone Center will be available for December 1981. Our meeting will be the first large meeting to be held in this new facility. However, Dr. Odom, his committee and the administrative staff have developed contingency plans so that if the facilities are not available, the annual meeting will proceed uninterrupted. Harold O. Perry, M.D. The Committee on tl'.c Annual National Meeting has done President~ 1981 a tremendous job in consolidating our program to avoid duplication and yet maintain the essential ingredients of a sound educational program. Courses on bacteriology, virology, and mycology were consolidated into one course on microbiology. The number of educational sessions offered at this year's meeting are 15 courses, 30 symposia, 45 forums, three laboratory sessions, 30 round table discussions, and 82 informal discussions. The larger teaching activities as well as the exhibits, both commercial and scientific, will bc housed in Moscone Exhibition Hall. As in 1978, the informal discussion groups will be held at the Hilton and the St. Francis Hotels. The Board of Directors of the Academy have made certain changes in the format of the Academy program. Because of increased financial costs, it was deemed necessary to increase the registration fee for the 1981 meeting. As a further cost-saving measure, participants in the Academy will no longer receive honoraria for their participation. However, when requested, faculty members will be reimbursed for expenses incurred in the preparation of visual aids. This year there will be a single Lila Gruber Lecture presented by Nobel Laureate Howard Temin, Ph.D., on

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Monday morning at 8:30 AM. The business meeting will begin at 9:15 AM and the remainder of Monday morning will provide an uninterrupted period for the Academy membership to conduct important business. Reports on the Headqumters Building, Administrative Survey, and fiscal policies will be discussed. During the business meeting, there will not be any scheduled educational programs and the exhibits will be closed. Therefore, all members should be able to attend the annual business meeting. While serving as your President during 1981, my efforts have been directed, in part, to try to consolidate and bring to a conclusion some of the programs that were initiated by our preceding president. 9 A new organizational structure, accepted by the Academy Board in 1980, was implemented. This program provides a means whereby Academy business can proceed in an organized manner. Dates of tenure have been set so that old members are automatically rotated off the committees, thus providing an opportunity for younger member appointment and participation. Approximately 30% of those who volunteered for Academy services were appointed to their chosen area of activity. 9 In contbrntity with the plans to acquire our new building, your Board of Directors, in May 1981, voted unanimously to purchase a new building for the headquarters office of the Academy in Evanston. 9 A review of the administrative operation of the Academy office was carried out by the President-Elect, John H. Epstein, and his report indicates the Academy office is a well-run, fiscally responsible organization for our administrative functions. 9 The Council on Government Liaison under the chairmanship of Dr. Peyton Weary has made a tremendous impression on all of medicine by his efforts to assure direct access of patients to specialty care. 9 I charged Dr. Thomas Murrell, Chairman, and the Finance Committee, to evaluate the fiscal policies of the Academy and make recommendations to the Board for the long-tem~ fiscal integrity of our Academy. 9 Vice-President James H. Graham and Chairman Henry E. Jones have studied areas where the membership of the Academy can be better served. This year a new session directed toward initiating new members into the Academy activities will be introduced. 9 Past President, Alfred W. Kopf, ehaimmn of the Task Force on Biomedical Communications, was charged to study ways in which the demaatologist's office could be computerized. At the time of this writing, it is planned to have an exhibit of the computerized office techniques, which will be the way of the future for the practicing dermatologist. We hope you will be able to visit this exhibit. 9 New approaches to preventive medicine programs for dermatology were deemed necessary. A new symposium on preventive dermatology has been added to the scientific program this year. 9 Your President has attended regional dermatology meetings to bring the Academy oflicers and administrative staff closer to the membership. San Francisco is a city of fun and festivity. Tours have been arranged so that alI may become better acquainted with the special cultural events of San Francisco and its environs. On Tuesday night, December 8, the new muscial production of Jerome Robbins "Fiddler on the Roof" featuring Herschel Bernardi in the lead as Tavia will be presented at the Orpheum Theater. Mr. Bradford Claxton and his very able staff have once again provided the support that makes our annual meetings possible. If you have suggestions regarding the program or arrangements, please contact Brad. I am looking forward with great enthusiasm to the meeting in San Francisco. I can assure each of you that the operation of the Academy is in capable hands. When personal illness prevented me from participating in plans for the 1981 meeting to the extent that I might have wished, our organizational structure and administrative offices have provided the necessary support so that the programs of the Academy could go forward. I think each of you should take great pride in the fact that the Academy is not one person, but the efforts of many. Those who consider the annual Academy meeting their most rewarding educational experience of the year will not be disappointed in the program for 1981. Serving as your president has been the greatest honor bestowed on me by American dermatology. To meet that challenge and to serve you has provided me with personal pleasure and gratification beyond all anticipation. 1 sincerely thank you for electing me your president. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

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In the program each year the president presents a message concerning the state of the American Academy of Dermatology (AAD). Each year the state of the AAD becomes more complicated, In the beginning our organization was involved primarily, or perhaps better ahnost exclusively, with education. This is still our overriding direction. However, with changes in health care structure, we find other issues creeping into our purpose for being. The AAD is indeed the voice of American dermatology since it is the only organization that represents essentially all members of our specialty. This brings us to the AAD now. What has happened in the past year, and where are we going? 1. First we had an outstanding meeting in 1981 in San Francisco, designed by the Council on the Annual National Meeting under the chairmanship of Dick Odom. We will have an equally superb meeting projectd by the Council of 1982 in New Orleans with Peter Lynch as program chairman. Your program tells the tale. John t1. Epstein, M . D . 2. The purchase of the building for out' organization has President, 1982 been completed and as expected many of our members wished to partake in the financial support of this effort. [t was a "good buy" as they say in the real estate industry. But more importantly it is time our organization found a home. We have one now and it is indeed attractive as well as costeffective. 3. The reorganization of the council and committee structure has continued under the direction of PresidentElect John Strauss and his Committee on Organization. This should be an ongoing process since our Academy needs are ever changing and require continuous reevaluation. 4. One of the primary aims of reorganization has been to rotate responsibilities on the various councils and committees to allow more of the membership to participate in the functions and activities of the A A D . At the end of this year, four of our council chairmen will have completed their terms of office. These include Paul Russell (Advisory Council), Peyton Weary (Government Liaison), Loren Golitz (Clinical and Laboratory Services), and Marie-Louise Johnson (Education). All of these individuals have supplied superb leadership and all of us owe them a great debt of gratitude. Although they arc rotating off their present positions, [ know they will continue to serve the AAD in their usual outstanding fashion. In addition, their replacements will undoubtedly continue their tradition of excellence. 5. Two newly formed committees of the Board of Directors were activated this year, the Audit Committee and the Priorities Committee. The Audit Committee's charge is to review in-depth areas of large expenditures to ensure their adequacy and propriety. This will relieve the Finance Committee of its "watch dog" role. Thus the Finance Committee can concentrate on long-range financial planning including investments. The Priorities Committee was formed to ensure that the direction of the activities o f the various councils is appropriate. Each council must submit a prioritized budget that will be reviewed by the Priorities Committee, who will advise the Board of Directors concerning appropriate levels of funding. 6. The Journal of the American Academy of Dermatology continues to grow in stature under the most able direction of Editor J. Graham (Skee) Smith. It is indeed one of our most important educational sources. 7. The computer systems developed by our Academy organization entitled Dermatology Management Information System (DERM/MIS) include seven inter-related subsystems with capabilities ranging from office management to literature search. 8. Vice President Sam Moschella and Gerald Gellin, Co-Chairmen of the Membership Committee, have continued to examine methods of involving new members in the activities of the Academy. Last year a session was held at the annual meeting in which the then President, Harold Perry, welcomed the new members. This appeared to be quite successful and will be rcpeatcd again this year. 9. The Fourth Annual Clinical Dermatology Conference was presented in April of this year. However, this year it was held in Chicago in conjunction with a number of Academy-sponsored symposia. This format proved to be a great success due in no small part to the Herculean efforts of Nick Rogers, who organized the program. This approach will be repeated next year again with Nick at the helm. 10. Perhaps the most important issue that involved American dermatology in this year relates to the concept

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of "direct access" to care by dermatologists. The issue has been the highest priority item for the officers and Board of Directors of the Academy second only to the educational needs of our membership. In December 1981, Harold Perry appointed a committee chaired by John Voorhees to advise the Board as to the best course of action concerning this problem. The committee met with a number of experts from health maintenance organizations, Blue Cross, and the public relations sector. In addition, half of the Board of Directors' meeting held in May 1982, was devoted to this problem. At the time of this writing the available information is being analyzed and an appropriate course of action will be initiated in the near future. This subject will be addressed at length at the Dec. 6, 1982, business meeting. 11. Last year, Harold Perry initiated the concept of visiting regional meetings to bring the membership closer to the AAD officers and staff. This was continued this year and I think it was a successful venture again. Last year, the meeting was held in San Francisco a city Harold Perry characterized as one of fun and festivity. Certainly, one can repeat that description for New Orleans. As you will note in your program there will be tours and trips to show you this channing and fun-filled city. In addition there will be an evening of entertainment on Tuesday, Dec. 7, 1982, beginning with the jazz musical revue "One Mo' time!" followed by a concert by Pete Fountain featuring the music for which New Orleans is famous. Our Executive Director, Brad Claxton, and his staff have again done their usual superb job of organizing and arranging. Thus the meeting will again run in its usual smooth manner. I assure you that this would not occur without the efforts of this fine group of people. In closing, I would like to thank you for allowing me to be your president this past year. This has been the most exciting and rewarding year of my dermatologic life. I do not believe I will ever have another one like it. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf. Jr., Archivist.)

Welcome to our Forty-second Annual Meeting in Chicago, our "home base" city. In returning to Chicago, we are once again able to have all our scientific sessions in one hotel complex, which is a unique advantage. However, our meeting decidedly is different this year in that it will start on Thursday instead of Saturday. The courses will be held on Thursday and Friday; the business meeting will be on Saturday morning, as will the Gruber Memorial Lectures. The program will end Tuesday noon. This is not a voluntary experiment: the rescheduling has been dictated by changes in hotel construction plans after the meeting was originally scheduled 8 years ago. Your officers wilt be very carefully watching our attendance records to determine whether this time change will be beneficial or not, and we hope you will comment on the timing. Our annual meeting is always the most impressive activity of the Academy and this year will be no exception. The Council on the Annual National Meeting, chaired by Milt Orkin, has put together a superb meeting, but this is not anything other John S. Strauss, M.D. than what we have come to expect and have had from all our President, 1983 chairmen of the Council on the Ammal National Meeting. Having had an opportunity to sit in on the Council's planning meeting, I can tell you that every member of the Council has given considerable thought to the selection of the topics and speakers for our Annual Meeting. The program will include 14 postgraduate courses, three laboratory workshops, 34 symposia, 58 forums, and 163 breakfast and luncheon sessions. Many new chairmen have been selected for individual sessions as we continue to involve as many members as possible in the Academy teaching activities. I want to call your attention to the unique opportunity that our membership will have to visit one of the outstanding museums of natural history on Sunday night. The Museum will be open only for our use that evening. Not only will we be able to see the regular exhibits at the Field Museum, but we will have the distinct pleasure of browsing in an Exhibit of the Treasures of the Shanghai Museum. This special exhibit will only be shown in two other cities in the United States. We are indeed fortunate that this exhibit will be at the Field Museum during the Academy meeting.

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The meeting is our most visible function each year, but therc are many other activities which are of importance to our membership. I will highlight some of these. 1. In many ways this has been a transition year in that four new Council Chairmen have been appointed. I am most pleased to inform the membership that the Advisory Council under its new Chairman, Jerry Stephens, the Council on Education under its new Chairman, Bill Gentry, the Council on Clinical and Laboratory Services under its new Chairman, Mark Daht, and the Council on Government Liaison under its new Chairman, Paul Russell, are performing extraordinarily well. All four chairmen have quickly grasped the nature o f their new positions and are increasing the scope of activities of their councils. They have been responsive to requests from my office throughout this year. 2. I am particularly pleased to report on the Council on Governmental Liaison. Peyton Weary is continuing to be our man on the Washington scene through his service as our Washington Representative from the Council on Governmental Liaison, but he no longer is burdened with the responsibility of running the Council. By separating the Council from Peyton's representative position, he has more time to devote to our Washington activities. Peyton and Paul Russell, with the able advice of Dr. John Grupenhoff, are working together to make the Council more responsive to our needs. For instance, Paul, with the help o f Ray Comelison, has designed a Key-Person Network that is capable of quickly contacting key Representatives and Senators when necessary. 3. The Journal of the American Academy of Dermatology has gone through infancy, puberty, and is now fully mature. A new contract has been negotiated with the editor, Skee Smith. We are assured of his expert leadership for another 5 years. 4. As mandated by the membership, we are implementing a public education campaign with the help of Hill and Knowlton. We will have a report from this group at our business meeting on Saturday. At the time that this message was written in June, a group of national spokespeople for the specialty have received speaker training from Hill and Knowlton. I was a member of this group. While I thought I was fully versed in how to handle the press and the media, I found the Hill and Knowlton sessions to be extremely useful. We have had considerable media exposure and, by the time of the meeting, Hill and Knowlton will have a full update of our activities. Be sure to come to the Business Meeting to hear their report. 1 am sure you will be impressed. The Council on Communications, chaired by Carlton Carpenter, has been working closely with Hill and Knowlton. This is Carlton's last year as Council Chairman. He deservcs our special thanks for the extra work that the public education program has created. 5. The Fifth Annual Clinical Conference was held in June. This successful second meeting of the Academy is now well established and will be expanded in the future to provide a second major educational forum for our members. 6. As I emphasized in my talk to the members at the annual meeting last year, better cooperation within the specialty is a necessity; long-range plans for such activities are in progress. Negotiations have been initiated with the Dermatology Foundation to develop a much closer working relationship that will be mutually beneficial to both organizations. The cooperation of these two groups is long overdue and hopefully this will be a reality before our annual meeting. Furthermore, a committee headed by our Secretary-Treasurer, Tom Jansen, is developing plans for better working relationships with the various subspecialty groups in dermatoIogy. In support of better cooperation I have continued the policy of my immediate predecessors and have represented the Academy at a number of regional ~md subspcciatty organizations. [ cannot help but feel that this is an extremely important activity for our future presidcnts. 7. Dermatology Services, Inc., our for-profit organization, is now active in providing services to our members. Larry Rosenthal, in addition to managing the financial activities of the Academy, is the Executive Vice-President for Dermatology Services, Inc. Many of the activities of Dermatology Services, Inc. are presently related to the computer operations. To improve these activities, a new committee, chaired by Mark Allen Everett, is fully investigating our management and educatiotaal computer programs. 8. As of the end of June, we have had considerable success in our efforts to raise the funds necessary for the remodeling and equipping of the National Education Center for Dermatology in our headquarters in Evanston. An update of our efforts will be presented at the Business Meeting, and we hope to have most of the financial commitments by then. I cannot close without mentioning the expert aid that I have obtained from our Executive Director, Brad Claxton, and all of his staff during this year. We in dermatology are extremely fortunate to have such a capable administrator among our midst. I can assure you that my presidency would have been much more difficult if Brad and his staff had not been constantly available to provide organizational and moral support. Cheryl Nordstedt has to be singled out for her management of our meeting arrangements. By handling all of our meeting arrangements internally, we are not only saving considerable money, but we have a constant watchdog looking out for and solving the many problems that always will arise.

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I also want to express my gratitude to the other officers as well as the entire Board of Directors for their help. Running the affairs of the Academy is truly a team effort. In closing [ want to thank each and every member of the Academy for electing me to the Presidency of this great organization. [ hope that l have been responsive to your needs. The Presidency of the Academy is the most honored position in Demmtology. l am extremely grateful to all of you for placing me in this position of trust and I assure you that the Academy will continue to bc in good hands with Dick Dobson this next year. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

Welcome to our Forty-third Annual Meeting in Washington, D.C., a fortuitous choice, since 1985 promises to bc a critical year for legislative action on health care issues that are likely to have a major impact on dermatologie practice. We arc indeed fortunate that the Council on Governmental Liaison, ably chaired by Paul Russell, is carefully monitoring the rapidly evolving political scene and ensuring that the voice of the Academy is heard when issues of vital importance to us are raised. Special thanks must also go to Peyton Weary and John Grupenhoff, whose wisdom and untiring efforts continue to serve each of us in more ways than can possibly be enumerated. In his presidential message, our itnmediate Past-President, John Strauss, described 1983 as a transitional year for the Academy. This year, too, has been a year of transition although challenging and critical may more aptly define the situation. Your approval of a special assessment last year has served to uncover both our strengths and weaknesses. In its traditional role as a preeminent postgraduate educational institution, the Richard L. Dobson, M.D. Academy united all its members in a commonality of need, President, 1984 interest, and purpose. As changing circumstances have required us to expand our activities and explore new initiatives, factionalism and devisiveness have surfaced, since in economic areas our concerns and needs are necessarily diversified. Despite these differences, we remain unified in our belief that the public deserves to maintain its right of access to high-quality medical care that only the welltrained specialist can best provide and that physicians should retain the right to practice in the setting of their choice. Regardless of inevitable changes in tile health care delivery system, it is only through a constant updating of our expertise and our commitment to quality that our services will continue to be required and demanded. The Council on Scientific Assembly, chaired by Harry Hurley, has provided us with an educational program that is outstanding in both scope and depth. A notable addition that will be continued in perpetuity due to the generosity of Mr. Murray Gruber, is the establishment of a Professor of the Year Award in memory of Marion B. Sulzberger. Steve Katz is the first recipient of this award and all are invited to hear his lecture in the Symposium, "What's New in Clinical Research." Another special program, generously funded by Westwood Pharmaceuticals, will train an additional 80 to 100 spokespersons selected by constituent societies of the Advisory Council. This year has been marked by a number of significant accomplishments: 1. Thanks to the efforts of the Committee, chaired by Henry Jolly, and the generosity of many of our friends in the pharmaceutical industry, development of our National Educational Center for Dermatology in Evanston is underway and will soon become a reality. I am pleased to report that this project will be completed at virtually no cost to our members and will provide us with invaluable services. 2. The Direct Access Conference, held in Washington in June, was highly successful. Peyton Weary, who organized the Conference, will report highlights during the annual business meeting. 3. A media seminar was held in New York City in March that was well attended by reporters from the major media. As a result, wide spread publicity was given to our specialty that emphasized the quality of care provided by dermatologists. I will give a comprehensive report on your Academy's public education campaign, as well as a full accounting of the use of your assessment funds, during the annual business meeting.

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4. Thanks to the joint efforls of the Task Force on Preventive Dermatology, chaired by James Howell, and the ad hoc Committee on Skin Cancer Detection Clinics, chaired by Faye Arundell, plans have been developed for a nationwide Skin Cancer Prevention and Detection Program to begin next spring. The details of this program will be presented during the business meeting. The management of Academy affairs is truly a team effort, and I woutd like to express my deep appreciation to our Officers and Directors as well as our Executive Director, Brad Claxton, and his staff for their advice and assistance during this challenging year. Those who would advocate radical restructuring of the Academy's system of governance are surely unaware of the effectiveness of our elected officers and our administrative staff. Special thanks are also due to the Blue Ribbon Committee on Dermatologic Practice and Public Issues, whose innovative approaches to major issues will serve us all well in the years to come. In closing, I would like to thank each of you for your confidence and support and your willingness to communicate your needs, concerns and suggestions to me. I am deeply honored to have had the opportunity to serve you. By identifying and openly discussing our problems, we have come through this year with greater unity of purpose and resolve. I am confident that with your continuing support the presidency of my successor, Clayton Wheeler, will be characterized by its great accomplishments. (Photography courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

Welcome to our Forty-fourth Annual Meeting in Las Vegas. The Council on Scientific Assembly and the faculty have prepared an exceptionally good offering this year. The facilities to carry out the program are superb and the rest of the environment is exceptional if one likes lights, shows, and games of chance. Many other things to do have been pointed out by the dermatologists of Las Vegas and their spouses and by the Academy office, including sightseeing, which offers a number of special opportunities. May everyone go home with increased professional knowledge, and having had a little fun in the bargain. We have added another lecture to the plenary morning session to provide a "half-day of the greatest educational value anywhere in dermatology." We have rean'anged meetings of the Board of Directors to allow these Academy members to have time to participate in the educational and scientific activities and to be more accessible to members. We are continuing to set aside time for members to meet with officers and directors Clayton E. Wheeler, Jr., M.D. to discuss items of mutual interest. We have added a symposium President, 1985 concerning the practice environment since economic and political issues are becoming increasingly important. A new computer course on the use of Medlars has been introduced. A onetime symposium on antiviral drugs and vaccines for herpes simplex and herpes zoster has been added, and the symposium on sexually transmitted diseases has been reinstituted. I hope, too, that we have brought back an air of dignity to the exhibit halls and to the afterhours activities. The ad hoe Goals Committee (some of the Board of Directors and all council chairs) met in November to collate and prioritize issues that had been identified by various components of the Academy. From this committee's activities, an agenda was developed for a 3-day meeting in San Diego (June 20 to 22) that was attended by 55 people, including the Board of Directors, staff, council chairs, resource persons of the American Academy of Dermatology (AAD), and 12 guests. The rapidly changing practice environment was thoroughly discussed, with emphasis on increasing controls exerted by the regulatory approach of the federal government and by the tree competition approach of private sector health care corporations (HMOs, IPAs, PPOs, for-profit hospitals, etc.) with resultant loss of controls by physicians and diminution of the fee-for-service practice sector. Emphasis was placed on bow physicians might retain appropriate controls over quality of health care and physician income. From the 3-day meeting the following major recommendations evolved: (1) establish a new Council on

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Political and Socioeconomic issues, (2) establish a Marketing Division of AAD with a full-time head, (3) market for direct access and for more patients, (4) activate the grass roots members and representatives of the Advisory Council, (5) enhance communication between members, officers, Board of Directors, staff, councils, committees, and task forces, i.e., between all Academy components, (6) develop a newsletter to supplement JAAD, the Bullethz, and Dear Colleague letters, (7) create a task force to monitor and report periodically on the practice environment, (8) educate dermatologists about the practice environment, (9) facilitate involvement of dermatologists in the practice environment at local, state, and regional levels, (10) work to unite physicians of all types, (1 l) facilitate the study of why some HMOs and IPAs have gatekeepers and some do not, (12) initiate a request for a proposal of a cost-effectiveness study, (13) charge a task force to develop standards of dermatologic care, (14) select a focus group to study the dermatologic consumer market, (15) create a task force to monitor decorum at the annual national meeting, (16) create a leadership development program, (17) upgrade the computer educational and informational program and select an editor comparable with that of JAAD, (18) explore malpractice insurance by the Academy, and (19) consider a membership category for residents. Obviously, no one can predict the impact of these meetings, workshops and programs. What one can say is that many members of the Academy have spent untold hours and have put tremendous thought and effort into these practice environment programs, not to mention into the educational programs of the Academy. The Directory of Councils, Committees, and Task Forces shows the names of some people involved, but the Directory does not contain the names of many who have worked hard on the home front. One of my goals last year was to appoint as many new people to committees and task forces as possible. Since only about one quarter of committee and task force members rotate off each year, spreading opportunities around is a slow process. Future presidents will undoubtedly feel the same way about getting as many new members involved as possible. It does not seem right to have some members on seven or eight committees and no place for other dedicated persons to work. An attractive and necessary alternative is to expand activities on the home front where there are unlimited tasks to be done and where much of the action will be. Many important activities have been carried out this year, evidence of what can be accomplished if we work together: (1) national skin cancer and melanoma screening programs, (2) Presidential Proclamation of the National Skin Cancer Prevention and Detection Week, and (3) training programs for Congressional aides. These three programs have done much to bring us national and Congressional recognition and credibility. Additional activities are: (4) monitoring drug-related groups, relative value scales, and cognitive versus procedural reimbursement, (5) expanding high-level educational programs, (6) continuing excellence of JAAD, (7) successful public relations activities, (8) support of research and support for inclusion of "skin" in the title of a new institute at National Institutes of Health, (9) relationships to the National Library of Congress, (10) completion of the National Education Center for Dermatology in Evanston, (11) passing a Federal Trade Commission review, and (12) appointing Paul S. Russell as the new Assistant Secretary-Treasurer. Space does not allow elaboration of these activities or listing of more programs. It has been a strenuous, time-consuming, and t~strating year. There is so much to be done and so little time in which to do it. There are so many obstacles to be overcome and so many trends that can be influenced very little. We should do everything that we can, but we should not spend precious personal and financial resources where there is no chance of success or where the effort is not justified. The wisdom to tell where we should place our efforts [s imperfect but we must choose and go ahead, Finally, the one thing that we do not need is a lack of unity within the several components of the Academy, and between the Academy and various other dermatologic societies. We cannot afford to be our own enemy. We must clean up our act; we must work together. The above programs and activities are not mine; they are not those of the Board of Directors; they are not those of the Academy office; they are ours. We are the Academy, not "they" are the Academy. I deeply appreciate the honor that you have bestowed upon me as President. I have done my best. I have tried to build on the efforts of the past and to provide a solid base for the future. The Academy office has been very supportive. You all have been very supportive. Thank you, all of you. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

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Welcome to our Forty-fifth Annual Meeting in New Orleans. Major urban construction and renovation has been completed since our 1982 meeting and has given downtown New Orleans a new look and feel. There are six new hotels within five blocks of the new "state-of-the-art" convention center. The center was opened in 1984 as part of the World's Fair, and is one of only a few convention centers in the United States designed specifically to accommodate medical meetings. The uniqueness of New Orleans continues to be its famous French and Creole cuisine, jazz nmsic, architecture, shops, and entertainment of the French Quarter, the neighboring plantation homes, and the scenic and historic areas along Old Man River. Two blocks from the convention center is a multilevel glassenclosed shopping complex featuring more than 50 famous shops and boutiques. For the second year, there will be a hospitality suite where spouses may enjoy daily refreshments and. entertainment. The traditional Tuesday evening Academy-sponsored entertainment Samuel L. Moschella, Jr., M.D. will be "Pete Fountain and Gumbo Ya Ya"--it is a most inPresident, 1986 teresting and intriguing story of the music that made New Orleans famous. The Council on Scientific Assembly, under the able Chairmanship of Dr. Donald Abele, has created an excellent opportunity for an unparalleled learning experience. The Lila Gruber Lecture will be given by the world-renowned Dr. Thomas A. Waldmann, Chief, Metabolism Branch, National Cancer Institute; and the Marion Sulzberger Lecture by our own outstanding member, Dr. Gerald Lazarus, Professor and Chairman of the Department of Dermatology at the University of Pennsylvania. There are sever:d new courses and symposia to address some of the needs of the current practice environment, such as "Interferon and Its Use" conducted by J. Corwin Vance; "Advanced Lasers" under the direction of John Ratz; "Dermatopharmacology" headed by Nicholas Soter; "Medical/Legal Problems" supervised by A. Bernard Ackerman; and "Hansen's Disease" (A Day at Carville) organized by me and Thomas Rea. Several special business meetings will be held by the Academy's officers and various dermatologic societies to promote unity and greater effectiveness when confronting challenges to out"specialty. Special opportunities will bc affordcd the membership to communicate directly with the Academy's leadership about their practice environment concerns. During the business meeting on Monday, I will give the presidential address. It will be a review of the Academy's programs, which are already in place or are being considered, that address the problems of our image: professionalism, cost-effectiveness, accessibility, and liability. I will assess, as well, what impact, if any, we have had on them. The major activities during the year were as follows: several conferences of the Long Range Planning Council with the leadership to develop strategic long-range planning for all areas of the Academy; our first, very successful leadership conference; the outstanding effort and accomplishment of the Melanoma/Skin Cancer Prevention and Detection Week; the signing of the proclamation by President Reagan and the encouraging impact made by the Academy's representatives as the House of Representatives Select Committee on Aging "Skin Cancer: Older Americans at Risk" chaired by the Honorable Edward R. Roybal; the establishment of the new Institute of Arthritis, Musculoskelctal, and Skin Diseases (NIAMSD); and the reaccrcditation of the Academy's continuing medical education programs by the Accreditation Council on Continuing Medical Education after meeting with representatives of our Council on Education under the capable leadership of William Gentry. Belbre closing, I want to express my appreciation and thanks to all our fellow dermatologists who give of themselves so unselfishly and intensely as council, committee, and task force members. I a/so want to call your attention to the expert aid, sensitivity, and quick responsiveness to the issues by our Executive Director, Brad Claxton and his staff, especially Larry Rosenthal, Ray Cunningham, Gil Martin, and Cheryl Nordstedt. I also want to express my deepest appreciation to our "minutemen" monitoring federal government activities for their alertness, prompt responsiveness, and their continuous strong support and guidance: Irwin Freedberg and his council and its committees, Peyton Weary, Bill Narva, Steve Katz, and John Gmpenhoff, our Washington representative. Our Secretary-Treasurer, Steve Webster, has also been very helpflll and most effective. Finally, l deeply appreciate the honor you have bestowed on me by electing me as your 1986 President.

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I have attempted to maintain the momentum created by my predecessor, Clayton Wheeler, and am confident that my successor, Dick Odom, will do likewise in a very effective and successful way. Wishing you a rewarding learning experience and a lot ot fun in New Orleans. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

Welcome to our Forty-sixth Annual Meeting in San Antonio. This is the Academy's first visit to this vibrant city, and I believe the membership will enjoy the social and cultural uniqueness of this rapidly growing urban community. The San Antonio dermatologic community has helped in the preparation of the "Guide to San Antonio." This special booklet will be distributed at registration, and provides detailed informarion on the history, culture, and sights of San Antonio. The Council on Scientific Assembly, under the superb leadership of Dr. Alan Shalita, has developed and implcmented a scientific program that is designed to provide us with an educational program that will cover the breadth of our specialty in a comprehensive manner. The Academy continues to maintain education as its highest priority and this year's program will once again demonstrate the superior quality of educational opportunities available to us through our annual meeting. The Lila Gruber Memorial Cancer Research Award Lecture will be given by Philip Leder, M.D. from Harvard Medical School. Richard B. Odom, M.D. The Marion B. Sulzberger Memorial Award lecturer will be President, 1987 Douglas R. Lowy from the National Institutes of Health. A new course on Intermediate Surgery will be added to the course curriculum in 1987. A special I-day symposium on adult immunodeficiency syndrome and new symposia oll Acne and Advanccd Pediatric Dermatology will be offered this year. The year 1987 has been a highly successful year for our specialty in terms of public relations efforts and continuing development of our public education programs. At the business meeting, I will detail the progress of our existing programs and apprise the membership of newer programs that are either in the developmental or implementa! phase. Also, I will cover the numerous activities and events that have occurred since our last meeting. Special emphasis will be placed on several major topics: (1) status of direct-to-consumer educational campaign; (2) National Invitational Conference--National Program for the Early Detection and Prevention of Malignant Melanoma and Other Skin Cancers; (3) "Making Children and Adolescents Sun Smart: The Importance of Sun Protection," American Academy of Dermatology and American Academy of Pediatrics--sponsored by Johnson & Johnson Baby Products; (4) Food and Drag Administration poster and learning unit, "The Darker Side of Indoor Tanning"; (5) "Let's Face It"--health education program on skin care sponsored by the Dermatological Division of Ortho Pharmaceutical Corporation; (6) "Skin-Deep"--a monthly health column for high school newspapers on subjects related to the skin, hair and nails; (7) Task Force for the Public Education of Younger Americans; (8) results of our skin cancer detection clinics; and (9) deliberations from the ad hoc Committee on Governance. During 1986, the Council on Long-Range Planning, under the direction of Dr. Robert W. Goltz, developed a long-range plan for the Academy. The Council developed a mission statement, established general objectives, proposed strategic guidelines, and created action plans to implement this program. This process clearly identified areas of concern and interest and will provide future directions for our organization for several years. During this past year, our councils, committees, task forces, and administrative elements have developed their future planning under the specific recommendations of the long-range plan.

Volume 18 Number 4, Part 2 April 1988

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I want to recognize and express appreciation to our Washington representatives--Peyton Weary, Bill Narva, Steve Katz, and John Grupenhoff--for their continuing efforts and achievements. Also, Lynn Drake and Bill Eaglstcin have provided great assistance during their health policy fellowship, and we look forward to having their expertise in the future. Our Executive Director, Brad Claxton, and his administrative staff continue to provide outstanding support and assistance, and consistently respond in an efficient and timely manner to new developments and additonal responsibilities. A special thanks to Steve Webster, our Secretary-Treasurer, for his counsel and enthusiastic support. Finally, I am profoundly grateful for having had the opportunity to serve as your President. I truly appreciate the efforts of our o~embers who have served our specialty through the Academy and through their state and local dermatology organizations. The Officers and Board of Directors have diligently performed their responsibilities and have been instrumental in implementing plans and programs that will assure a position of importance and esteem for our specialty in the future of medicine. I hope that you will find the 1987 Annual Meeting educatior.ally rewarding and a socially satisfying experience. (Photograph courtesy of the American Academy of Dermatology, John E. Wolf, Jr., Archivist.)

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