Cold Iron Truth

Legislative Conference 2019


Unreasonable step therapy and prior authorizations, overly expensive generic drugs, opposition to a 5-year Medicare pay freeze, surprise medical billing, and the risks and benefits of sunscreen use for the prevention of skin cancer.

Dr. Brett M. Coldiron, a dermatologist and Mohs surgeon in Cincinnati.

Dr. Brett M. Coldiron

These were just some of the hot button issues that 156 of my fellow dermatologists brought before a record-breaking American Academy of Dermatology Association Legislative Conference in Washington. We also were joined by 49 patients and practice administrators for this terrific meeting filled with classes and speakers. Members of Congress joined us at various sessions and social occasions with good food, fine wine, and great conversations. Radio personality and CNN host Michael Smerconish gave a very funny speech at dinner and had comments about civility in politics. The comradery was excellent and the intellectual food for thought was extraordinary – right up the alley of dermatologists who are also political junkies.

Most congressional representatives are not well versed in health care topics. As a result, we spent a good deal of time on education – speaking to junior staffers who are expected to keep the members of Congress updated on what they need to know about medical and, specifically, dermatologic issues. As many refer to Washington as “the swamp,” you can consider the House members to be the “big gators,” and the staffers the ”little gators.” Taking that analogy further, lobbying (or educating) then logically becomes “gator wrestling.”

Most of the time we met with little gators, although this year we also met with 84 big gators. We took turns telling them true stories based on our patients’ problems with abuses within our health care system. I think these stories are effective. This is your representative government in action!

On the last day of the conference, we made personal calls by state on the hill offices. Some groups, like Ohio, were nine strong! Everyone gets to speak. This year’s meeting was attended by a total of 31 dermatology residents, and the residents from Ohio State and Cleveland Clinic who participated in our state meetings were terrific. In all, we covered 228 offices – 157 Congressional and 71 Senate.

Rep. John Joyce, MD, FAAD (R-PA-13) was on hand and is the first dermatologist elected for a full term to Congress. Anyone at the meeting could have spent all the time they wanted with him discussing our issues. He is most knowledgeable and a great asset for our specialty. Dr. Joyce is recognized as a dermatologist by his fellow representatives, and even by Speaker Nancy Pelosi and President Trump. For 30 years, Dr. Joyce has been a proud member of the American Academy of Dermatology, as is his wife Dr. Alice Joyce, who also is a dermatologist and continues to run their practice, Altoona Dermatology Associates.

Dr. Joyce is a true asset to dermatology. As an individual, I advocate supporting his campaign financially if you get the chance, beyond just what SkinPAC can give him.

In sum, the AADA Legislative Conference is a lot of productive fun. You get to network with all the leaders of the AAD, as well as many of the leaders of the United States. If you donate $5,000 to SkinPAC, they will pay your way to the conference. If you contribute $1,000, you get to go to the high-donor dinner (The same goes for a $50 donation from residents, no typo!). What’s not to like about that? Most dermatologists like a good party. Next year’s meeting is Sept. 13-15, 2020. See you there!

Dr. Coldiron is in private practice but maintains a clinical assistant professorship at the University of Cincinnati. He cares for patients, teaches medical students and residents, and has several active clinical research projects. Dr. Coldiron is the author of more than 80 scientific letters, papers, and several book chapters, and he speaks frequently on a variety of topics. He is a past president of the American Academy of Dermatology. Write to him at

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