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Team-based approach incorporates non-physician clinicians


While non-physician clinicians cannot replace dermatologists, the role they play in dermatology practices is growing. However, there are key factors to consider, one expert says, including team structure, supervision and training.

The trend toward a growing workforce of non-physician clinicians in dermatology, including physician assistants, nurse practitioners, registered nurses, and medical assistants will certainly continue in the future with greater demand for dermatological care.

“Healthcare is incentivizing their use,” says David Pariser M.D., a dermatologist in Norfolk, Va., and professor of dermatology at Eastern Virginia Medical School. He spoke at the 73rd annual meeting of the American Academy of Dermatology (AAD, San Francisco, 2015) about the role of non-physician clinicians in dermatology practices.

“Healthcare reform will bring forth more work for dermatologists, and the question is who will see all these (new) patients,” he says.

The expansion of non-physician clinicians is not unique to the specialty of dermatology, but has taken hold in other medical specialties, such as pediatrics, plastic surgery, and cardiology, to name a few, Dr. Pariser says.

Recognizing the growth in non-physician clinicians in dermatology, the AAD has put forth that a team-based approach in dermatology can be implemented with a goal to successfully deliver dermatological care, with the dermatologist playing the role of team leader or captain, Dr. Pariser says.

“The philosophy of the Academy (AAD) is that we lead the team,” Dr. Pariser says, saying a team-based approach will help preserve the specialty of dermatology.  “I firmly believe that the concept of team care allows us to provide high-quality care to a larger number of patients, keeping dermatology viable as an organized specialty.”

Dr. Pariser stresses that non-physician clinicians cannot replace dermatologists.

There are some items to address with the growth in non-physician clinicians in dermatology practices such as ensuring that dermatologists are on-site, playing a supervisory role in the practice, and examining the level of training of non-physician clinicians working in dermatology practices, and perhaps standardizing training of non-physician clinicians, Dr. Pariser says. 

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