Expand your capacity, income through nonphysician providers

April 1, 2006

National report ? There may be close to 10,000 dermatologists in the United States, yet the power of this number is weakening as practices struggle to meet capacity demands and their patients' needs in some parts of the country.

With appointments booking three-to-four months out for the simplest of skin checks, many patients are turning to family physicians, internists and OB/GYNs for their skincare needs. Yet many dermatologists are finding they can maintain and often increase their patient load, in addition to increasing their income, through one simple step: adding a physician extender or nonphysician provider.

In an era where a key focus within practices is on cosmetic procedures, the widening gap between those dermatologists who offer medical dermatology is being felt by patients across the country, causing the largest increase in dermatology providers to be dermatology-trained physician assistants (PAs), according to dermatologic surgeon W. Philip Werschler, M.D., F.A.A.D., F.A.A.C.S.

Buying time, income

"It's hard for second- and third-tier cities throughout middle America to recruit dermatologists," says Dr. Werschler, who also maintains a private practice in Spokane, Wash. "At the end of the day, the easy answer is that you're going to hire a PA because they're plentiful and they're eager to work in dermatology."

Physician assistants are far from being a problem for the dermatology profession, and may be the only answer to seeing numerous patients in a timely manner while offering superior care, according to Joe R. Monroe, PA-C, M.P.A.S., a physician assistant specializing in dermatology.

"Physician assistants, who number around 65,000 to 70,000 nationwide, are not a new concept. We've been around for 40 years, and in dermatology for almost the entire time," says Mr. Monroe, who is also president of the Society of Dermatology Physician Assistants (SDPA). "The vast majority of dermatology PAs work in solo offices with private practice dermatologists."

"By having someone handle your follow-up patients, to see acne or do the cosmetic procedures, it buys you time without a reduction in income," Dr. Werschler contends. "If you're booked 75 percent of the time for more than two weeks in advance, the addition of a PA will allow you to see more patients more quickly."