Mover & shaker: Derm dedicates decades to the profession, patients

Professional involvement is the thread that runs through Dr. Mikell's career. His activity in organized medicine went into high gear when managed care took hold in the 1990s.

"Managed care was a huge threat to the whole country and a tremendous problem for California, New York and Florida. We in South Carolina were trying to prepare for it," Dr. Mikell tells Dermatology Times.

The network would share substantial financial risk, either by accepting capped rates or by withholding a minimum of 20 percent of fees as a risk pool that would be retained by the network or distributed to its members only if promised efficiency goals were achieved.

"That was a big deal at the time," he says. "I was invited to lecture to the Ohio Derm Society about managed care and gatekeepers. I also drafted, and we negotiated, a direct access bill. We had a legislator sponsor the bill, and we hired a lobbyist. After much negotiation with the insurance carriers, we got a direct access bill passed in the state of South Carolina."

Past president of the state's dermatology association and past secretary and treasurer of the South Carolina Medical Association, Dr. Mikell also volunteered with the American Academy of Dermatology's State Watch, a task force set up to give momentum to the activities of state societies. State Watch then presented an award to the South Carolina Society for meeting its criteria for excellence.

Early ideals

"When I was an undergraduate majoring in international relations, the emphasis was on development of underdeveloped countries, and I thought through international banking, I could be helping other countries to become developed," Dr. Mikell says.

"But the more I thought about it, the more I realized with the turmoil in the world, I might spend my entire life helping some underdeveloped country that would then have a revolution and decide they did not like me at all. My entire life would then have been wasted," he says.

This was during the Vietnam War, and Dr. Mikell was well into his military career at the time, teaching Navy ROTC. He discovered the military's program for active-duty personnel in medical school. The career sounded like something he wanted to pursue.

"I thought about treating and making one person happy at a time as a reward," he says.