“The advanced practice professional (APP) will see you now,” states the nurse as she brings the patient to the examination room. The expansion of health professionals from physicians to nurse practitioners and physician-assistants is allowing for patients to be seen more promptly in clinics and hospitals across the country. Medical schools are also expanding their class sizes to graduate more doctors to provide more prompt access to care. I graduated medical school two years before the expansion of our class size, which grew from 142 students to a whopping 250 graduating per year. The question in the era of today’s cost-cutting measures while maintaining good care is this: Does seeing an APP (a physician assistant or nurse practitioner) mean lower healthcare costs while equaling the same quality of care?
In the August 2015 dermatology edition of the Journal of American Medical Association, a study was conducted to determine the number of skin biopsies (skin removed from a patient using a blade or scalpel) necessary by physicians versus APPs to diagnose forms of skin cancer in two categories: all skin cancer other than melanomas, and melanomas.
The results were statistically significant in all categories, revealing that APPs will perform almost twice as many biopsies to diagnose a cancer versus physician dermatologists, who performed half as many biopsies to diagnoses different forms of skin cancer. The use of biopsies may increase unnecessary pain and cost of care provided by APPs when compared with that provided by board certified dermatologists.
It’s prudent to seek a board-certified dermatologist for concerns regarding skin cancer and mole examination. Four years of residency after medical school prepares the skincare physician in unique ways that are superior to the clinical training of an APP. While APPs are highly qualified to treat many conditions, this study substantiates the expertise of board certified dermatologists.