Department of Medicine, Santa Barbara Cottage Hospital, Santa Barbara, California, USA.
Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
Clin Dermatol. 2020 May-Jun;38(3):303-309. doi: 10.1016/j.clindermatol.2020.02.004. Epub 2020 Feb 19.
The corporatization of dermatopathology has long preceded that of dermatology and has been driven by federal legislation and economic influences. Although the Clinical Laboratory Improvement Amendments and the Stark Law limited physician-owned laboratories, loopholes via the Safe Harbor Exemptions outlined in the Anti-Kickback Statute allowed corporate laboratories to flourish through relationships built by health information technology donations. The rise of corporatization has had widespread effects on the fields of dermatopathology and dermatology, resulting in reduced numbers of dermatology-trained dermatopathologists and decreased caseloads in academic institutions, potentially compromising dermatology residency education. Although there have been efforts to counteract these effects, more global changes will be required to alter the direction of this subspecialty.
皮肤病理的公司化运作早已先于皮肤科,并受到联邦立法和经济因素的推动。虽然《临床实验室改进修正案》和《斯塔克法》限制了医生所有的实验室,但《反回扣法规》中安全港豁免的漏洞允许公司实验室通过医疗信息技术捐赠建立的关系蓬勃发展。公司化的兴起对皮肤病理和皮肤科领域产生了广泛的影响,导致皮肤科培训的皮肤科病理学家数量减少,学术机构的病例量减少,可能会影响皮肤科住院医师教育。尽管已经有一些措施来抵消这些影响,但需要更广泛的全球变革来改变这个亚专业的方向。