Dermatologist Takes the Helm as AMA President

Jack Resneck Jr., MD, is not usually the loudest voice in the room, but when he speaks, his words carry a heft and an appeal that is straightforward and undeniable.

That was on full display as the 51-year-old vice chair of dermatology at the University of California, San Francisco, addressed his colleagues in his inaugural speech as president of the American Medical Association (AMA) on June 14.

He did not mince words when it came to describing the current landscape. “I doubt you imagined a divided country such as this, where physicians and public health officials often face antiscience aggression and threats of violence simply for doing our jobs,” he said. “You probably didn’t plan on insurers questioning every prescription and every procedure you asked for. Or government criminalizing routine and vital healthcare, enshrining discrimination against our LGBTQ patients or attacking a woman’s right to control healthcare decisions that should only be between her and her doctor,” said Resneck.

But, he added, all was not lost. “While it would be easy to get overwhelmed by despair as I begin this new role, I’ve never been prouder of my physician colleagues,” he said.

Resneck is the first dermatologist to lead the 175-year-old organization since 1925. Colleagues in the field speak of pride in having one of their own at the top, and they are even more complimentary about his depth of health policy knowledge, his communications skills, and his ability to find common ground.

“He loves looking at both sides,” said Marta Van Beek, MD, MPH, clinical professor of dermatology at the University of Iowa Carver College of Medicine, Iowa City. “That’s how he builds consensus,” said Van Beek, who has known Resneck for more than 20 years, since they were chief dermatology residents — she at Iowa and he at UCSF.

Van Beek and Resneck both have a deep interest in health policy and have long worked side-by-side on committees at both the American Academy of Dermatology (AAD) and the AMA. She looks back to the lead-up period before the 2010 passage of the Affordable Care Act as one of Resneck’s shining moments. “Those were contentious times in medicine,” Van Beek told Medscape. Resneck, as chair of the AAD’s Council on Government Affairs and Health Policy from 2008 to 2012, rallied the board to agree on a set of healthcare reform principles, she noted.

Resneck is “really very unifying,” agreed Bruce Brod, MD, clinical professor of dermatology at the University of Pennsylvania Perelman School of Medicine, Philadelphia. Brod has worked with Resneck for two decades on various committees at the AAD. They’ve also known each other through the AMA House of Delegates.

Now Brod is following in Resneck’s footsteps as chair of the AAD’s Council on Government Affairs and Health Policy. “Big shoes to fill there,” said Brod. He said he’s been inspired by Resneck’s always-positive approach, punctuated by his ever-constant belief that “there’s a lot more common ground than meets the eye here.”

“I really think he’s the perfect leader at this time,” he said.

Outgoing AMA President Gerald Harmon, MD, said that Resneck’s long experience as a teacher and a mentor, and what he describes as a “good, active listening talent,” have been integral to his success as a leader. He expects those qualities to make Resneck an effective advocate for all of medicine. “He identifies the problem, he identifies the gap, and then he establishes a workable, executable plan to close that gap,” Harmon told Medscape, adding that he’s seen this at work in AMA board meetings.

“He was a good teacher for me,” said Harmon, who had known Resneck through the House of Delegates and various AMA councils for at least a decade before they both joined the AMA board. “He can be such a mentor to all age groups, including senior physicians like myself,” said Harmon.

Resneck is excited, but also measured. “This has been a tumultuous couple of years in the country with the pandemic and with the fractured politics,” he told Medscape. Thinking about taking on the AMA presidency, he said, “I’ve had some moments of trepidation. I wanted to be sure that I was going to be able to make a difference.”

Long Interest in Health Policy

Growing up in Shreveport, Louisiana, as the son of a dermatologist, Resneck said “at first, I swore I was going to do something other than medicine.” It was not out of rebellion. He got along fine with his father. He wanted to pursue his own journey.

Resneck began his long love affair with health policy at Brown University, graduating magna cum laude with honors in public policy. A 1991 US Department of Health & Human Services internship between his junior and senior years helped inform his honors thesis on healthcare financing policy.

Ultimately, Resneck did not stray far from his father’s career path. While still at Brown, he decided to go to medical school, entering UCSF in the fall of 1993. “At the end of the day, there was this undeniable influence that he loved his job,” Resneck told Medscape. His father was energized by the work and helping patients. “If burnout was in his vocabulary, I never heard it,” said Resneck.

Initially, Resneck did a 1-year internal medicine residency at UCSF, but then switched to dermatology and became chief resident in 2000.

He was quickly pegged as a leader and an inspirational speaker. The AAD gave him its Young Physician Leadership Development Award in 2001, and the AMA gave Resneck its Excellence in Medicine National Award for Young Physician Leadership in 2004. He began giving talks at national meetings in 2002 and has been busy ever since, addressing the AMA, the AAD, state medical and dermatology societies, subspecialty groups such as the American College of Mohs Surgery and the Association of Professors of Dermatology, and other organizations such as the American Telemedicine Association.

He’s a sought-after speaker in part because of his ability to simply communicate health policy, said Brod. “He can connect the real-world issues really well to the policy needs and communicate it very well, and come in at just the right level,” he said.

Resneck has been immersed in policy and practice issues since the start of his career, serving on AAD and AMA committees addressing quality measures, data collection, access to care, workforce issues, and telemedicine. He started writing about dermatology workforce challenges in 2001 and has revisited that topic with regularity.

He has published often on the difficulties of patient access, looking at wait times for appointments, among other issues. In 2018, he expressed concern in a commentary in JAMA Dermatology that private equity purchases of dermatology practices might lead to an improper focus on profits over patients and that it could reduce the diversity of practice models.

At heart, Resneck is an institutionalist, someone who believes that the “collaborative, collective voice can make change,” said Brod. Resneck said as much in his inaugural speech. “I believe those who show up can use levers of power to confront our system’s flaws,” he said. “This is the nerdy policy part of my life, which my friends will force me to admit is most of my life,” said Resneck.

Prior Authorization, Telemedicine, Equity

Beneath the reserved exterior lies an intense yearning to act on his passions, both at work and at play.

Resneck notes almost in passing that he likes to ski when he’s not practicing medicine or serving on a committee. Van Beek — whose family has vacationed with Resneck, his wife, Ellen Hufbauer, MD, a family medicine physician in Concord, California, and their two teenaged children Zachary and Amelia — said he’s “a very good skier.”

She noted that he and his kids share the same enthusiasm for researching every aspect of wherever they travel, including the best places to eat. “He embraces work and life with an incredible amount of intellectual curiosity,” Van Beek said.

That curiosity — and the passion to make a difference — has driven his deep dives into what he sees as the corrosive practice of prior authorization and the promise of telemedicine, which he has explained and supported in testimony on Capitol Hill.

Brod said that Resneck was among those who helped convince the federal government to expand coverage for telemedicine during the COVID-19 pandemic. “He brought together his patient experience in dermatology and his policy experience,” and was able to deftly explain how it could increase access during the shutdown, said Brod.

Prior authorization gets him fired up. “We’ve reached a point where there’s almost not anything I will write a prescription for that doesn’t oftentimes require all of these hoops that we have to jump through,” he told Medscape. Prescriptions for generic topical cortisones that have been around for 50 years “now all of the sudden require a week of arguing,” said Resneck. In the meantime, patients aren’t getting treatment, he said.

Resneck’s passion for health equity is borne in part out of the racism witnessed by him and his family, including an uncle who started an antisegregationist newspaper and was kicked out of medical school for his views in the 1950s. Resneck said he had a rudimentary understanding of racism as a kid. But he told the AMA delegates, “I knew enough at age 16 to write an op-ed in our city’s newspaper about the need to remove Confederate monuments from our courthouse lawn.” Added Resneck, “You can imagine how that went over in 1987.”

The pandemic shined a bright light on inequities and heightened awareness of “the institutionalized systems that have perpetuated racism and gender discrimination in medicine for as far back as we want to look,” said Resneck during his inaugural speech. Pointedly, Resneck told his colleagues that “the AMA has not always been on the right side of history,” adding, “Each of us must do our part to eliminate health inequities by engaging in antiracist and antisexist work.”

That kind of talk is signature Resneck, said Brod. “He’s not afraid to exhibit very brave leadership,” especially “when there are issues that jeopardize the needs of patient access or patient safety,” he said.

“He’ll be a tremendous AMA president,” said Van Beek. “He’s present, he’s devoted, and he’s typically the expert in the room.”

Harmon said that Resneck is “cut from the same cloth that I am. He believes that if you get an opportunity to make things better, you take it.”

His advice to Resneck: “rarely turn an opportunity down.” Harmon has little doubt that Resneck is not up to the job but said, “I’m going to encourage him to keep that energy and enthusiasm up.”

Resneck told physician colleagues not to worry: “I will keep relentlessly showing up.”

Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including JAMA and You can find her on Twitter @aliciaault.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

Source: Read Full Article