Nonphysician Clinicians Provide Wide Variety of Dermatology Services To Medicare Patients Interview with:

Adewole Adamson, MD, MPP Department of Dermatology UNC – Chapel Hill North Carolina

Dr. Adamson

Adewole Adamson, MD, MPP
Department of Dermatology
UNC – Chapel Hill North Carolina What is the background for this study? What are the main findings?

Response: Nurses practitioners and physician assistants, collectively known as non-physician clinicians (NPCs), provide many dermatology services, some which are billed for independently. Little is known about the types of these services provided. Even less is known about where these independently billed services are provided. Given that there is a purported shortage of dermatologists in the United States (US),  NPCs have been suggested as way to fill in the gap.

In this study, we found that NPCs independently billed for many different types of dermatology associated procedures, including surgical treatment of skin cancer, flaps, grafts, and billing for pathology. Most of these NPCs worked with dermatologists. Much like dermatologists, NPCs were unevenly distributed across the US, concentrating mostly in non-rural areas. What should clinicians and patients take away from your report?

Response: Nurses practitioners and physician assistants provide a variety of procedures to Medicare beneficiaries from the basic to the complex and bill for them independently. Most of these NPCs work with dermatologists and are less likely to live in rural counties. What recommendations do you have for future research as a result of this study?

Response: The quality of care delivered by Nurses practitioners and physician assistants that bill independently is unknown, therefore understanding this will be important area of future research. If NPCs will be an important part of increasing access to dermatology services, figuring out ways of incentivizing NPCs to fill in health care delivery gaps in rural counties will be important moving forward. 

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Adewole S. Adamson, Elizabeth A. Suarez, Philip McDaniel, Paul A. Leiphart, Alana Zeitany, Joslyn S. Kirby. Geographic Distribution of Nonphysician Clinicians Who Independently Billed Medicare for Common Dermatologic Services in 2014. JAMA Dermatol. Published online November 22, 2017. doi:10.1001/jamadermatol.2017.5039

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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