PracticalDermatology

Concerning “The Elephant In The Exam Room: Emerging Dermatology Qualifications of Different Stripes and Types” featured in the March 2022 issue of Practical Dermatology® magazine, the Society of Dermatology Physician Assistants (SDPA) would like to clarify its stance on several points presented by the authors.

First and foremost, the SDPA supports the utilization of appropriate and accurate nomenclature when describing non-physician clinicians and their associated qualifications and certifications in the clinical setting. SDPA prefers the name “PA” or DermPA be used to address a physician assistant practitioner in the practice setting.

Regarding PA educational requirements and opportunities, PAs must have achieved at least a bachelor’s degree (older education model), with the current entry to practice requirement being a master’s degree. PAs may continue their education and seek a doctorate, with the credential typically denoted only by signature in the practice setting.

Further, the authors of this article made note of two separate exams, which the SDPA feels need clarification. First, the National Board of Dermatology Physician Assistants (NBDPA – previously ABDPA) developed an elective board certifying exam for PAs practicing in dermatology, despite the SDPA’s vocal opposition to this concept since its inception in 2019. The SDPA’s stance is that the National Commission on Certification of Physician Assistants (NCCPA) is the only certifying entity with the authority to grant a board certification for PAs in the United States, which is currently the PANCE/PANRE.

In contrast to a board specialty certification, the proposed NCCPA CAQ (Certificate of Added Qualifications) in the specialty of dermatology mentioned in the article is currently in development as an elective “recognition” certificate. This comprehensive program and exam will be available to PAs practicing in the dermatology specialty upon meeting certain career and exam requirements. The CAQ is not a requirement or pre-requisite for a DermPA to practice in dermatology, nor is it a specialty board certification. The resulting CAQ-DERM credential will demonstrate a DermPA’s knowledge, experience, and commitment to the field of dermatology and our patients.

SDPA polled its members, and the majority of responders were in favor of a CAQ in dermatology. In contrast, a majority are against a PA board certification in dermatology as many SDPA members embrace the traditional PA model allowing PAs to practice across specialties wherever their passion lies or skills are best utilized.

The SDPA leadership hopes that this additional information helps to clarify some points from the above referenced article. The SDPA is steadfast in our mission to support a team-based approach, working alongside our dermatologist colleagues, to educate and train DermPAs and provide top-notch skilled patient care to those in need. We maintain that superior onboarding, continuing medical education, transparency, and consistency in messaging offers the best opportunity to accomplish these mutual goals.

— Society of Dermatology Physician Assistants Board of Directors
Alexandria, VA

Reader Reacts to Coverage of ABD “Professionalism Requirements”

I read Dr. Schlessinger’s May 2022 editorial and concerns with the recent efforts by the American Board of Dermatology to “update professionalism requirements.” (Available online at here) This is nothing more than a very obvious attempt to have the thoughts, ideas, writings, and very identity of individual dermatologists controlled by a few privileged and “enlightened” members of the Board. The attempt to make “misinformation” a cause for board certification removal should be chilling to everyone.

We in medicine are so wise and godlike! Think about the FDA approval of thalidomide, the use of x-ray radiation to treat acne which caused basal cell cancers we remove regularly, the push for hormone replacement in menopausal women before we realized it caused breast cancer, and the latest debacle of recommending for decades a baby aspirin to everyone over 50.

I wrote a lot on the survey, all of it against the idea, but will share the following which summarized my concerns (and which I sent also to the Board):

I want to make a comment. How is it possible that numerous medical boards have existed in the United States for over 100 years without this sudden need for all the boards to now have a uniform policy on professionalism? You write below: This new professionalism policy is based on requirements of the new ABMS Standards for Continuing Certification.

Patients know who the professional physicians are and avoid those who are not. It has been thus for hundreds of years.

Call me cynical, but I really don’t think a detached “American Board of Dermatology” speaks for the myriad viewpoints and ideas of their members. I think this new interest in “professionalism” is a way to create “group think” for me and my colleagues that aligns with your interests, and ultimately with the American Board of Medical Specialities, and even higher interests.

I hope I am wrong, but I doubt it.

—Avery Bevin, MD, FAAD