Defending the Procedural Moat: ASDS New Leaders Tackle AI and Pay

SAN DIEGO, CA – November 09, 2026 — When medical societies announce their annual election results, the press releases are traditionally exercises in polite congratulation. Yet, reading between the lines of the American Society for Dermatologic Surgery (ASDS) 2026 leadership announcement reveals a specialty bracing for a profound structural transformation. The elevation of Dr. Deirdre Hooper to President and the election of Dr. David Ozog as Vice President signal a strategic realignment for the organization. This is not merely a changing of the guard; it is the mobilization of a specialty facing a triad of existential pressures: the rapid encroachment of artificial intelligence, a steady erosion of reimbursement rates, and intensifying scope-of-practice battles.

As the largest specialty organization representing dermatologic surgeons, the ASDS—and its advocacy arm, the ASDSA—wields significant influence in the house of medicine. The surgeons they represent are the pioneers of Mohs micrographic surgery, cosmetic dermatology, and complex reconstructive procedures. But as the new leadership terms began on November 6 at the Annual Membership Meeting in San Diego, the underlying mood was one of urgent preparation. Outgoing President Dr. Kavita Mariwalla handed over an organization that must now navigate what incoming Vice President Dr. David Ozog aptly described as "unquestionably the most transformative decade procedural dermatology has faced."

Guarding the Procedural Moat in the Age of AI

The most striking signal from the ASDS election is the explicit acknowledgment of artificial intelligence not just as a clinical tool, but as a potential displacer of medical expertise. Dr. Ozog, who chairs the Department of Dermatology at Henry Ford Health and will ascend to the ASDS presidency in 2028-29, centered his platform on a concept he calls the "procedural moat."

In business strategy, an economic moat is a competitive advantage that protects a company's market share. For dermatologic surgeons, the procedural moat is the tactile, highly specialized surgical skill that, for now, cannot be replicated by an algorithm. While AI models have demonstrated remarkable proficiency in analyzing dermatological images and assisting in melanoma detection, the actual physical intervention—the precise excision of a tumor, the nuanced reconstruction of a facial defect—remains firmly in the domain of human expertise.

"The patient remains the center of every decision I have made over 25 years of Mohs and reconstructive practice," Dr. Ozog stated, emphasizing that the "sacred trust earned through evidence, expertise and unhurried judgment must anchor every position ASDS takes." He specifically identified "artificial intelligence and the procedural moat" and "scope of practice in an AI era" as top priorities.

This focus suggests the ASDS is preparing to establish firm clinical and ethical guardrails around automated technologies. The organization's strategy will likely involve leaning into the irreplaceable nature of surgical intervention while simultaneously integrating AI to enhance imaging, pathology analysis, and workflow. As one healthcare technology analyst observed on the sidelines of the conference, "The societies that survive the AI revolution won't be the ones that fight the algorithms; they will be the ones that define exactly where the algorithm stops and the scalpel begins."

The Reimbursement Squeeze and the Battle for Scope

While AI represents a looming, structural shift, the immediate crisis facing dermatologic surgeons is economic. The incoming 2026-27 Board of Directors, which includes newly elected members Dr. Elizabeth Billingsley, Dr. Rebecca Kazin, and Dr. Seaver Soon, inherits an increasingly hostile reimbursement landscape.

Year after year, the Centers for Medicare & Medicaid Services (CMS) has implemented cuts to the Medicare Physician Fee Schedule, creating a compounding financial strain on specialized medical practices. Mohs surgery, highly effective but resource-intensive, has frequently been caught in the crosshairs of these valuation debates. Commercial payers have been quick to follow Medicare’s lead, driving down reimbursement while simultaneously increasing the administrative friction of prior authorizations and claim denials.

Dr. Rebecca Kazin directly addressed this economic reality, stating, "Through its advocacy efforts, the organization has defended appropriate reimbursement and championed patient safety. I am committed to continuing this work and advocating for the critical issues facing dermatologic surgery."

The fight over reimbursement is inextricably linked to the ongoing scope-of-practice battles. As private equity consolidation drives corporatization in healthcare, there is immense financial pressure to delegate complex procedures to non-physician providers (NPPs), such as nurse practitioners and physician assistants. The ASDSA has historically drawn a hard line against independent practice for NPPs in dermatologic surgery, arguing that the extensive residency and fellowship training of board-certified physicians is non-negotiable for patient safety.

This stance is becoming harder to defend in state legislatures heavily lobbied by NPP organizations seeking expanded practice rights. The ASDS leadership must now navigate a dual-front war: lobbying federal agencies to halt payment cuts while simultaneously fighting state-by-state skirmishes to ensure that complex dermatologic procedures remain under the direct supervision of fully trained surgeons.

Passing the Scalpel to the Next Generation

To sustain this multi-front defense, the ASDS is acutely aware that it must mobilize its youngest members. The generational turnover within dermatologic surgery brings a new cohort of practitioners who are highly connected, technologically fluent, but also burdened by unprecedented medical student debt and entering a fundamentally altered practice environment.

"Ensuring that we engage the next generation of dermatologic surgeons, with the patient expectations and challenges unique to their era of technological connectedness, will be critical to our continued success," Dr. Seaver Soon noted. His background bridging private practice and academic environments positions him to address the diverse operational challenges facing young dermatologists today.

This sentiment was echoed by Dr. Elizabeth Billingsley, who emphasized that "the future is in our youngest members, and we need to capture their energy, enthusiasm, creativity and initiative to continue to grow even further."

This is not mere lip service. The ASDS has formally institutionalized this priority by appointing Resident Representatives to the Boards of Directors, ensuring that the perspectives of those currently navigating Accreditation Council for Graduate Medical Education (ACGME) training requirements are heard at the highest levels of governance. The society is also heavily investing in educational technology, virtual surgical planning tools, and mentorship programs to bridge the gap between residency training and the harsh realities of modern practice management.

The environment these young surgeons are entering is complex. Dr. David Laub, newly elected to the Nominating Committee, succinctly summarized these hurdles as "the changing perception of our profession, rising costs, increasing administrative complexity, technological changes and shrinking reimbursements." His call for leaders with "experience, integrity, adaptability and resilience" is a clear directive for the society's future recruitment efforts.

As the 2026-27 leadership term gets underway, Dr. Hooper, Dr. Ozog, and the newly configured board face a landscape that is fundamentally shifting beneath their feet. The ASDS is no longer just a forum for sharing surgical techniques; it has become a necessary fortress for a specialty under siege. By fortifying the procedural moat, aggressively lobbying for fair valuation of their expertise, and mentoring a resilient new generation of surgeons, the society's new leaders are attempting to secure the future of dermatologic surgery in an era that threatens to commoditize it.