Dermatopathology in Clinical Practice: Avoiding Abuse of Self-referral and Client Billing

Dermatopathology is as important to the specialty of dermatology and the care of patients with skin disease as is any element of the specialty. The American Academy of Dermatology (AAD) has long supported the right of dermatologists to provide dermatopathology services and to choose their preferred dermatopathologists. Physician self-referral and client billing exist, in theory and in practice, to ensure access to high-quality dermatopathology services; unfortunately, both also are subject to real or perceived financial, ethical, and professional abuse, and have attracted critical attention from other specialty societies and policymakers. The dermatologist’s ability to provide dermatopathology services and to bill clients is at risk because these practices are viewed as potential sources of increased utilization and cost. To protect our specialty and our patients, dermatologists must avoid business arrangements that prioritize revenue over patient care.