Dermatologists vote on whether to punish board's North Little Rock founder

A national outcry over the establishment of a board to certify physician assistants specializing in dermatology has led to efforts to remove the dermatologist behind the Little Rock-based board from his position in the American Academy of Dermatology and to dissolve the new board.

Scott Dinehart, a North Little Rock dermatologist, violated his fiduciary duties to the academy "through his actions to incorporate and name himself the sole organizer of the newly-launched American Board of Dermatology Physician Assistants (ABDPA), an organization that intends to provide 'board certification' to physician assistants who work in dermatology practices and meet certain requirements," the academy president, George Hruza, said in a statement posted on the academy website.

A website for the new organization has been taken down and, according to the Arkansas secretary of state's office, the articles of incorporation for a limited liability company organized by Dinehart called ABDPA, which are the initials of the new board, has been dissolved. It was incorporated on Sept. 27.

Both Dinehart and Matthew Reynolds -- a physician assistant at Dinehart's office, Arkansas Dermatology, and the new board's executive director -- were out of the office Monday, according to a person who answered the telephone Monday afternoon.

Nearly 2,300 people had signed a petition supporting the initiation of Dinehart's removal from the American Academy of Dermatology. According to the petition, 1,600 signatures were require to go forward with the removal process.

The petition attracted many comments critical of the endeavor.

"As a board certified dermatologist, I can't turn a blind eye to a leader of the profession who undermines what my education, board certification, and years of training mean," one commenter said. "There is a palpable conflict of interest when deliberate confusion is created for patients by using language of 'board certification in dermatology' for physician assistants.

"This is a money grab, from a man who benefits financially from PAs being able to confuse patients about the interchangeability between doctors and PAs by a made-up 'board certification.' We deserve representation that is more concerned about elevating our profession than elevating the financial bottom line."

Removing Dinehart from the dermatology academy received a unanimous vote among its board, according to Hruza's statement.

"The new American Board of Dermatology Physician Assistants 'certification' could mislead patients into thinking that physician assistants with this certification have training and experience equivalent to [academy] board-certified dermatologists and/or should be able to practice independently, without physician supervision," Hruza said.

A special removal vote began Monday and is scheduled to end Oct. 29.

According to the academy bylaws, removal of an elected officer of a board member requires a two-thirds vote of at least 10% of voting members. The academy has 15,272 eligible voting members, according to Nicole Dobkin, an academy spokesman.

The American Board of Dermatology Physician Assistants was announced Oct. 7 in a news release, which said the new board would assess and certify dermatology physician assistants who meet specific educational, training and professional requirements.

In an interview at the time, Reynolds said he wanted to fill a void in the profession and establish a national standard of excellence for physician assistants who devote their careers to dermatology.

The board was separate and independent from the National Commission on Certification of Physician Assistants, which is the only certifying organization for physician assistants in the United States. The commission said its certification assures the public that certified physician assistants meet "established standards of clinical knowledge and cognitive skills upon entry into their practice and throughout their careers."

The national commission also offers physician assistants specialty certificates of added qualifications in seven medical fields: cardiovascular and thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopaedic surgery, pediatrics, and psychiatry.

Physician assistants certified through the American Board of Dermatology Physician Assistants would be required to maintain their certification through the National Commission on Certification of Physician Assistants, but Reynolds said he wanted a separate venue to recognize the dedication of physician assistants in the dermatology field.

Reynolds' organization also was independent from the Society of Dermatology Physician Assistants, which is the largest specialty organization among physician assistants and offers continuing medical education for physician assistants who specialize in dermatology.

The society issued a statement on Oct. 8 formally objecting to the new board, saying it had "no authority to grant a 'board' certification where a board does not exist."

The society also said it couldn't support an exam "that has not undergone the vigorous psychometric analysis required to qualify as an accurate examination."

The Little Rock board had said it would offer an exam twice yearly that would cost $450 for first-time applicants. The exam planned for February included 125 multiple-choice questions, and physician assistants who passed would be certified by the Little Rock board for seven years. Physician assistants who wanted to be recertified would be charged a $300 fee.

"The Society of Dermatology Physician Assistants ... was not privy to the development of any certifying exam for Derm PAs nor believes there is a need or authority to do so," the society said.

Physician assistants are health care practitioners under the supervision of a physician. In addition to receiving national certifications, they have state licenses to practice. In Arkansas, they are licensed by the state Medical Board.

In Arkansas, there are 443 licensed physician assistants, according to Tara Bruner, a physician assistant in family practice in Searcy and president of the Arkansas Academy of Physician Assistants.

Bruner was the first to express skepticism about the new board. She couldn't be reached for comment Monday.

In an interview when the board was announced, Dinehart said he believed patients want information on their health care providers, saying that certification often serves as a signal of competency.

"I think people have a little more confidence in someone who is board certified," he said Oct. 7. "You know they've been through a course of study, you know they've taken a test in their field."

Business on 10/22/2019