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Approximately 50 percent of dermatologists in the US work with Physician Assistants (PAs) and Nurse Practitioners (NPs) currently, and that number is expected to grow, as there are simply not enough dermatologists to care for all those who need it. For those who are considering adding a PA to the practice, this information may help with the decision. Dermatology is a highly sought-after specialty among physicians and PAs alike, so there will continue to be PAs looking to practice with dermatologists.

PAs: A Backgrounder

A little background on PAs may be helpful. PAs are trained in the medical model, and training has been compared to the first and third years of medical school. This was based on the compressed training of physicians during World War II. For the past 50 years PAs have been caring for patients in all medical specialties in the US. The first PAs were returning Vietnam medics with significant experience in the field but no comparable civilian opportunities. Even now, most PA programs require the equivalent of at least two years of prior healthcare experience and a good understanding of the role of the PA in team practice prior to acceptance to a program. Other countries are beginning to use PAs, as well, since the concept has worked so well in the US.

PAs Across the US

According to the 2016 Statistical Profile of Certified Physician Assistants, an annual report of the National Commission on Certification of Physician Assistants, there are currently 115,500 certified PAs working in the US. From 2010 to 2016, the number of certified PAs in the US has increased by 44 percent.

The majority of certified PAs in the US (71 percent) have a Masters Degree.

The survey found that approximately four percent of dermatologists nationwide work in dermatology, representing a total of 3,589 PAs.

—Practical Dermatology® Staff

Because dermatology is such a highly sought-after specialty, PAs bring enthusiasm to the dermatology office. Medical school, including PA training, is widely accepted to provide inadequate preparation in dermatology. PA programs generally do an excellent job of ensuring graduates understand the limitations of their shortened medical education and as a result PAs are prepared for a steep learning curve in any new position. They are ready and eager to learn what you and the patients have to teach. Working with a PA is an opportunity to truly multiply your hands and impact many more patients than you could on your own. Though it takes time and energy, training a PA in your style of practice results in a provider whose judgment you can trust to be most like your own. A strong, mutually trusting, and respectful personal relationship between a PA and physician results in a loyal employee. A PA well trained by you is going to serve your community better than having those patients cared for by primary care providers with little dermatology-specific training.

The prior life of a PA can result in a provider with some special skills to offer. A PA who formerly worked as an MA may have a bond with the current MA staff and would make a great supervisor. A PA who was a pharmacist is a great resource in the office when it comes to medications, interactions, and the like. A former CNA will have a heightened level of empathy and understanding of the difficulties of daily life for those who live with limitations and may be able to offer suggestions for coping strategies. Becoming a PA is a deliberate choice after seeing some of what life has to offer, and PAs are grateful to be able to provide the level of care that they do. Like the physicians we work with, it is not a choice made for prestige and money, but in the service of others.

Burnout among healthcare providers is a problem that is currently being widely discussed. Dermatologists have until recently been less affected, but that is changing due to administrative burdens. The shorter duration of demanding medical education for PAs and the flexibility of the profession together contribute to lower rates of burnout among PAs. This can have an uplifting and energizing effect in the office. A provider that is happy to come to work each day and take care of patients can brighten the mood for all. It helps to remind the staff why we are all here and put the focus back on the patient where it belongs.

A Welcome Addition

A medically educated provider with prior experience and life skills who is enthusiastic, grateful, and burnout resistant can be a welcome addition to your very busy dermatology practice. A well trained and supported PA who has a strong relationship with the dermatologist is likely to remain in that practice long-term and provide stability and continuity of care to the patients who deserve nothing less.

Jennifer Winter, MPAS, PA-C is in practice in Olympia, WA. She is a past president of the Society of Dermatology Physician Assistants and serves as the current chair of the Public Education committee.

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