The appeal of dermatology as a specialty is not limited to the US. Recently published results of a survey of Australian medical students show that, while surgery, internal, and intensive care medicine earned highest marks for their “prestige” factor, dermatology, general medicine, and public health are seen as optimal choices from a “lifestyle” ranking.
Among American medical students, competition is strong for the nation's limited dermatology residency slots. As the specialty assesses a possible workforce shortage, some urge for new dermatology residency opportunities. Others note that nurse practitioners and physician assistants are effectively filling the gaps in person power with good results.
For its part, the American Academy of Dermatology officially recognizes the contributions of non-physician providers in its new position statement, “The Practice of Dermatology: Protecting and Preserving Patient Safety and Quality of Care.” As described in AAD publications, the statement seems to acknowledge a longargued sentiment: more competition for dermatology patients is coming from physician providers outside of dermatology than from non-physician providers trained by and working side-by-side with BC/BE dermatologists.
The statement makes clear that a dermatologist is a “residencytrained physician specialist fully educated in the science and art of cutaneous medicine.” Importantly, however, the statement also describes a dermatologist as the head of a team of highly trained and well-supervised medical professionals who make diagnoses, administer therapies, and perform procedures as their training, supervision, and local regulations allow.
While the number of nurse practitioners and physician assistants working in dermatology is much lower than the number of those working in other fields of medicine, their growth in the specialty has been rapid, and demand remains high. The AAD is moving in the right direction by acknowledging the reality that the provision of efficient dermatologic care is possible through the use of non-physician providers. Dermatologists are, as the statement notes, experts in “diagnosis, treatment, or correction” of conditions affecting the skin, hair, nails, and mucus membranes. Properly trained and supervised non-physician providers allow more patients access to that expertise.