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The ABMS strikes back
Journal of the American Academ y of Dermatolo gy
238 Correspondence
nevus and speckled lentiginous nevus are closely related to melanocytic or nevus cell proliferation:': how ever , I think they are unique clinical pictures with different dermatologic presentations. Mr. GilsonAndradeSimoes (fromSanta Monica, CA) provided all the photographic equipment for this study.
Gildo Andrade Simoes, M.D . Rua Itabaiana, 394 (CLASE) 49000 Aracaju, Sergipe, Brazil
REFERENCES I. Matsudo H, Reed WB, Homme 0, et al: Zosteriform lentiginous nevus. Arch Dermatol 107:902-905 , 1973. 2. Port M, Courniotes J, Podwal M: Zosteriform lentiginous nevus with ipsilateral rigid cavus foot. Br J Dermutol 98:693-698 , 1978. 3. Ruth WK, ShelburneJD, Jegasothy BV: Zosteriform lentiginous nevus. Arch Dermatol 116:478, 1980. 4. Stewart OM, Altman J. Mehregan AH: Speckled lentiginous nevus. Arch Dermatol 114:895-896, 1978. 5. Cohen HJ. Minkin W, Frank S8 : Nevus spilus . Arch Dermatol 102:433-437. 1970.
The ABMS strikes back To the Editor: Consumerists have carried on for years in the mode described by Melvin A. Glasser in "Recertification and Relicensure: A Consumer's Viewpoint," which appeared on page 73 of the January, 1981, issue of the JOURNAL. I have not seen any broad feeling, or for that matter any feeling, among patients that will support his concerns. I am rather surprised with the article and think it must have been written some years back. The
reason is that his peers today are concemed not with yesteryear's crusade but with the costs of health care, which they deem as •'too expensive . " Nothing is more sure than an increase in costs , if recertification (i.e. , the American Board of Medical Specialties) carries the day . There is no evidence that recertification does anything positive for doctors or their patients to justify the cost of this procedure, which, ultimately, is paid by the patient. Many hazards of recertification have been pointed out. Two of these are as follows: I . Recertification, even if voluntary, once set in place, may prove to be mandatory in reality, in terms of hospital appointments, hospital privileges, and fee schedules. 2. Because of the legal ramifications , Boards may have to give recertification exam inations to physicians who were not originally certified . This would weaken the entire certification structure. As a member of the Joint Committee on Recertification in Dermatology, I am aware that many spe cialty soc ieties are questioning the appropriateness and value of recertification . Their numbers are increasing. Recently , the American Medical Association suggested a moratorium on recertification so that a s tudy could be done to determine the effectiveness and contribution of current programs; and to determine the cost in time and money the amount of benefit to the patient, and the total effect on the phys ician. I think that this makes excellent sense . I
Harvey J. Cohen, M.D. 170 Maple Ave. White Plains, NY 10601
238 Correspondence
nevus and speckled lentiginous nevus are closely related to melanocytic or nevus cell proliferation:': how ever , I think they are unique clinical pictures with different dermatologic presentations. Mr. GilsonAndradeSimoes (fromSanta Monica, CA) provided all the photographic equipment for this study.
Gildo Andrade Simoes, M.D . Rua Itabaiana, 394 (CLASE) 49000 Aracaju, Sergipe, Brazil
REFERENCES I. Matsudo H, Reed WB, Homme 0, et al: Zosteriform lentiginous nevus. Arch Dermatol 107:902-905 , 1973. 2. Port M, Courniotes J, Podwal M: Zosteriform lentiginous nevus with ipsilateral rigid cavus foot. Br J Dermutol 98:693-698 , 1978. 3. Ruth WK, ShelburneJD, Jegasothy BV: Zosteriform lentiginous nevus. Arch Dermatol 116:478, 1980. 4. Stewart OM, Altman J. Mehregan AH: Speckled lentiginous nevus. Arch Dermatol 114:895-896, 1978. 5. Cohen HJ. Minkin W, Frank S8 : Nevus spilus . Arch Dermatol 102:433-437. 1970.
The ABMS strikes back To the Editor: Consumerists have carried on for years in the mode described by Melvin A. Glasser in "Recertification and Relicensure: A Consumer's Viewpoint," which appeared on page 73 of the January, 1981, issue of the JOURNAL. I have not seen any broad feeling, or for that matter any feeling, among patients that will support his concerns. I am rather surprised with the article and think it must have been written some years back. The
reason is that his peers today are concemed not with yesteryear's crusade but with the costs of health care, which they deem as •'too expensive . " Nothing is more sure than an increase in costs , if recertification (i.e. , the American Board of Medical Specialties) carries the day . There is no evidence that recertification does anything positive for doctors or their patients to justify the cost of this procedure, which, ultimately, is paid by the patient. Many hazards of recertification have been pointed out. Two of these are as follows: I . Recertification, even if voluntary, once set in place, may prove to be mandatory in reality, in terms of hospital appointments, hospital privileges, and fee schedules. 2. Because of the legal ramifications , Boards may have to give recertification exam inations to physicians who were not originally certified . This would weaken the entire certification structure. As a member of the Joint Committee on Recertification in Dermatology, I am aware that many spe cialty soc ieties are questioning the appropriateness and value of recertification . Their numbers are increasing. Recently , the American Medical Association suggested a moratorium on recertification so that a s tudy could be done to determine the effectiveness and contribution of current programs; and to determine the cost in time and money the amount of benefit to the patient, and the total effect on the phys ician. I think that this makes excellent sense . I
Harvey J. Cohen, M.D. 170 Maple Ave. White Plains, NY 10601