Why Expertise Is Important

A recent study published in JAMA Dermatology provided cold, hard evidence supporting what most board certified dermatologists suspected for a long time: Physician Assistants (PAs) perform more biopsies and miss more skin cancers, including the deadliest form of skin cancer, melanoma.   JAMA Dermatology  reported that “compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists.”

What does this mean for you as a patient?  Monetarily, it means you are paying more for unnecessary biopsies of benign lesions.  Psychologically, it means you are put through unnecessary procedures and left with scars that may not be necessary.  Medically, it means skin cancers and deadly melanomas are being missed at a greater frequency despite additional biopsies; perhaps because the wrong growths are being sampled.

Board Certified Dermatologists undergo years of training.  My recent blog post details our expertise. The American Academy of Dermatology released a web page detailing the differences between a Physician Assistant, Nurse Practitioner and a Dermatologist.  

When discussing the dangers of bargain cosmetic treatments, which are becoming increasingly common with memberships, med spas, and Groupons, a friend opened my eyes to an important point.  She commented, "everyone knows they are more risky, but what they don't realize is they can actually be more expensive."  I had explained to hear that an expert injector can actually do more with less.  One syringe of filler in my hands placed properly goes much further than two or three syringes in the hands of an inexperienced injector who misplaces the product.  Botox or Dysport that is over-diluted or inappropriately placed can require additional units to achieve the same result.  Increased risks aside, you are likely to spend more money for a less cosmetically appealing outcome with a non-expert injector.  You really do get what you pay for in life.  Same goes for medical care.  This study supports what we already know:  all providers are not created equal.  Physician Assistants, Nurse Practitioners, and Dermatologists undergo very different training.  Physicians are not "providers," we are doctors and lumping us as "providers" only aims to confuse patients.  

This study is important because it highlights not only the cosmetic side of dermatology, which can get more airplay, but the medical side as well.  With all medical professionals wearing long white coats and being lumped together as "providers," I think it is very important for patients to know the difference. Hard evidence shows there is a very real financial, psychological and medical distinction in who is taking care of you.