THE ROLE OF THE PART-TIME PHYSICIAN-TEACHER IN DERMATOLOGY

As we approach the 21st century, specialty training programs in dermat ology are feeling increasing pressures that have begun to erode clinic al teaching, Full-time faculty members are being asked to spend more t ime in patient care to support an increasing portion of their income o r are spending more time to develop laboratory data and write grant ap plications to survive in a brutally competitive academic world. Other faculty members are leaving academic medicine for private practice hav ing decided that the risk-reward ratio is no longer acceptable. In Cal ifornia, the state government has implemented a plan that decreases sp ecialty residency positions and their funding in favor of primary care positions. Third-party payers are becoming more restrictive in paying for inpatient and outpatient dermatologic services. Dermatologic inpa tient, services in some university teaching programs have been elimina ted. Third-party payers are also balking al subsidizing teaching and r esearch activities at teaching hospitals.