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Dermatology Practices Turning to Non-Physician Clinicians

Use of nurse practitioners and physician assistants has increased significantly since 2002

WEDNESDAY, Feb. 13 (HealthDay News) -- Because of a nationwide shortage of dermatologists and persistently long patient wait times, dermatologists are increasingly turning to physician assistants and nurse practitioners to meet patient demand, according to a report published in the February issue of the Journal of the American Academy of Dermatology.

Jack S. Resneck Jr., M.D., of the University of California San Francisco School of Medicine, and Alexa B. Kimball, M.D., of the Department of Dermatology at Harvard Medical School in Boston compared the responses of 1,243 dermatologists to the American Academy of Dermatology's 2007 practice profile survey with responses to surveys conducted in 2002 and 2005.

The researchers found that the number of dermatologists who reported using physician assistants, nurse practitioners or both in their practices increased from 20.7 percent in 2002 to 29.6 percent in 2007 (a 43 percent increase). Although respondents reported supervising non-physician clinicians on-site 92.8 percent of the time, 31 percent reported that they were off-site during 10 percent or more of business hours. Therefore, nurse practitioners and physician assistants were usually allowed to see new patients and established patients with new problems under indirect supervision. The researchers also found that 36.2 percent of respondents expect to hire non-physician clinicians by the year 2010.

"In the absence of explicit consensus or policy as to how the field should ensure future access for patients with skin disease, growth in the use of non-physician clinicians is rapidly changing the landscape in which dermatology is practiced," the authors conclude. "Further data on the evolving use of these non-physician clinicians and the consequences for both patient access and quality of care are undoubtedly needed."

Resneck disclosed receiving a career development award from the Dermatology Foundation, and he chairs the Workforce Task Force of the American Academy of Dermatology.

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