AADA Policy

• The AADA supports mandatory emergency transfer protocols for medical offices where surgical services are provided, at all levels of anesthesia services, where these protocols do not mandate hospital transfer agreements.

• The AADA opposes mandatory requirements for hospital staff privileges (at all levels), hospital admitting privileges and hospital transfer agreements as requirements for physicians constitute economic credentialing.

• The AADA opposes actions that result in restraint of trade for dermatologists.

• The AADA supports fair and impartial mechanisms to allow dermatologists to procure credentialing at appropriate levels.

Message Points

• Dermatologists traditionally have been at the forefront of providing quality patient care in the office setting that is safe, comfortable and convenient.

• The AADA also opposes requirements that dermatologists performing office-based procedures have written agreements with hospitals stating that their patients can be transferred to that hospital in an emergency. These agreements are not needed to ensure patient safety and often are not made available to doctors who do not have privileges at the hospital.

• Though many dermatologists have hospital privileges, some do not, and most dermatology is practiced safely, conveniently and affordably outside of the hospital in an office setting.

• Some states are considering requiring that dermatologist who perform office-based surgery have privileges to perform the same procedures in a hospital. The AADA believes these requirements do not promote patient safety and could restrict patients’ access to safe, convenient and affordable office-based care.

• Although office-based dermatologic procedures are extremely safe, the AADA believes all dermatologist should have a protocol – a plan – for transferring a patient to a hospital in case of an emergency resulting from a surgical procedure. These protocols may include written agreements with a licensed ambulance service to transport patients to a specified hospital.

• The available data does not show that complications are any less common in offices where the physician has hospital privileges.

• Patients having office-based procedures should ask about how medical emergencies are handled, and what happens if they need hospital care.