CME4Life Synapse 
What is Dermatology?
Dermatology is the branch of medicine that deals with health issues affecting the skin, hair, nails, and mucous membranes.
The skin is the first line of defense against bacteria, viruses, UV rays, pollution, and chemical substances that we encounter in the environment. Skin regulates body temperature and maintains fluid balance. Skin is also the body’s largest sensory organ and can detect stimuli such as pain, pleasure, temperature, and pressure.
The factors detrimental to skin health are:
- Unhealthy diet
- Stress
- Lack of sleep
- Sedentary lifestyle
- Dehydration
- Smoking
- Side effects of medication
- Environmental pollutants
Genetics, aging, hormones, and conditions such as diabetes can also affect the skin.
If your skin problem is persistent, it is best to err on the side of caution and see a skin doctor or a dermatologist.
Who is a dermatologist?
A doctor specializing in treating skin, hair, and nail conditions is called a dermatologist.
In the US, a qualified dermatologist is a doctor certified by the American Board of Dermatology, the American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada.
What conditions does a dermatologist treat?
A dermatologist can treat up to 3000 and more conditions, but a few of the most common ones are:
- Acne
- Dermatitis and eczema
- Fungal infections
- Hemangioma
- Hair loss
- Warts
- Nail problems
- Vitiligo
- Psoriasis
- Rosacea
- Shingles, or herpes zoster
- Skin cancer
What are the procedures performed by dermatologists?
Dermatologists perform a variety of medical and cosmetic procedures to treat issues of the skin, nails, and hair, such as:
- Chemical peels
- Cosmetic injections
- Cryotherapy
- Dermabrasion
- Excision of lesions
- Hair removal or restoration
- Laser surgery
- Vein procedures
- Tumescent liposuction
- Skin grafts and flaps
- Biopsies
- PUVA
- Mohs surgery
The gap in supply and demand of dermatologists
With skin conditions on the rise, there is an increased demand for dermatologists in the medical community. Alexa Boer Kimball cites in an article in Pudmed, “Since 1999, multiple surveys have documented a stable undersupply of dermatologic services in the United States. Factors contributing to the imbalance include changes in the demographics of the physician workforce, increased demand for services, and a limited number of training positions for new physicians.” This has resulted in long wait times to see a dermatologist. Treatment costs are also high, and not many can afford them. If insurance does not cover a dermatology visit, an initial consultation could range from 150$ to 200$.
The role of physician assistants is being examined for providing American healthcare with highly qualified professionals who can provide specialized skincare.
Who is a dermatology physician assistant?
A certified dermatology physician assistant is a medical professional who is licensed to practice medicine in collaboration with a dermatologist.
Becoming a dermatology physician assistant requires a bachelor’s degree and a master’s degree from an accredited physician assistant program.
The PA curriculum covers 12 months of in-depth instruction in introductory, behavioral, and clinical sciences. This is followed by 12 to 18 months of supervised clinical practice experiences in various specialties. PA students interested in Dermatology can complete an elective rotation in the Dermatology specialty.
Scope of work of a dermatology PA
A dermatology physician associate examines and diagnoses skin-related health concerns, administers treatments, and monitors patient progress, all under the supervision of a licensed dermatologist.
- Physician assistants work in medical dermatology settings, evaluating and treating:
- Acne
- Rosacea
- Atopic dermatitis
- Contact dermatitis
- Psoriasis
- Warts
- As physician assistants receive surgical training as part of their master’s program, their surgical skills are used in minor surgeries like:
- Cryotherapy
- Electrocautery
- Shave, punch, and incisional/excisional biopsies
- Excisions and minor repairs
- Physician associates receiving advanced training in surgery by their supervising physicians could assist them in Moh’s surgery to perform complex closures, including flaps and grafts.
- Dermatology physician associates can be honed with skills to provide laser and other light-based therapies.
- In the cosmetic surgery setting, physician assistants can handle treatments like:
- Botulinum toxin injections
- Fillers
- Chemical peels
It must be remembered that physician associates can only practice medicine that is within the scope of services provided by their supervising physician.
What is the outlook for a dermatology PA?
Dermatology is predominantly an outpatient service. The need for less schooling compared to a physician, a robust job market, an average pay scale of $115,390 per year, less stress than other specialties, regular hours, and high job satisfaction makes Dermatology a very attractive job practice. According to the US Bureau of Labor Statistics, employment of physician assistants is projected to grow 31% from 2020 to 2030, much faster than the average for all occupations.
Physician assistants have contributed to narrowing the gaps in dermatological medical care by evaluating and treating common skin disorders, leaving dermatologists time and energy to handle the more complicated cases, thus easing their work burden and meeting the care needs of a much larger number of patients. They also provide care at a lesser cost and with shorter wait times. This has led to them gaining incredible acceptance and recognition in their profession from physicians and patients alike.
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