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Official website for the University of Miami Leonard M. Miller School of Medicine
med.miami.edu
This is scary, especially with independent practice.
At least not until they open their own derm clinic in south FL....."Participants will observe patient care and will not have directly care for patients."
Who do we report this to at the AAD?Boomer greed knows no bounds.
I don’t know why I’m surprised, but this is ridiculous. An ACGME accredited program shouldn’t be able to demand a certain level of competence from the residents and turn around and “train” mid levels with a half assed shadowing experience to the tune of $50k “tuition”. Should email and complain to the ACGME, AADA, AAD, etc. Dinehardt got pushed out at AAD for trying to start a PA licensing board, not sure how this is all that different.
My guess would be some combination of Mohs, cosmetics, and reading dermpath.What do the Derm MDs do in your area?
Also using their own superficial x-ray machines to treat skin cancers. The non mohs ones anyway.My guess would be some combination of Mohs, cosmetics, and reading dermpath.
Spot on, the mid levels biopsy everything.I once watched a dermpath friend read for a bit and it was insane what some of the PAs and NPs were sending to him. Like reams of specimens A through F in a single patient, all benign. I asked him about it and he was like “oh yeah, a lot of these mills send in like a 5% abnormal rate. They just biopsy a bunch of stuff randomly”
Not sure if that’s just to drive up reimbursement, or sheer incompetence— probably both. But its mutilating patients (and their finances). Sad.
I would say my benign to malignant ratio is probably 40/60 which is what it should be. And I’m counting mild/mod ATN in the benign category.
If you are like 1 in 20 — might as well be the janitor doing your biopsies.
Not only PAs are way too trigger-happy with a blade, but the main problem is that their biopsies are much more likely to be nondiagnostic, and may prompt further work-up. This is how it works:I once watched a dermpath friend read for a bit and it was insane what some of the PAs and NPs were sending to him. Like reams of specimens A through F in a single patient, all benign. I asked him about it and he was like “oh yeah, a lot of these mills send in like a 5% abnormal rate. They just biopsy a bunch of stuff randomly”
Not sure if that’s just to drive up reimbursement, or sheer incompetence— probably both. But its mutilating patients (and their finances). Sad.
I would say my benign to malignant ratio is probably 40/60 which is what it should be. And I’m counting mild/mod ATN in the benign category.
If you are like 1 in 20 — might as well be the janitor doing your biopsies.
IF thats the way they are gonna do it then force the NP and the PA to train the ancillary staff to do it as well like the LPNs.Not only PAs are way too trigger-happy with a blade, but the main problem is that their biopsies are much more likely to be nondiagnostic, and may prompt further work-up. This is how it works:
PA takes 3-6 biopsies of random stuff. Writes 'R/o malignancy' or 'nub' on everything (no pun intended). The biopsies tend to be small, superficial, fragmented and squished. Therefore oftentimes the final report includes some sort of hedge, like, 'deeper biopsy recomended', SCC cannot be ruled out etc. Which engenders a new visit, which generates more biopsies, billing etc. Oh and it also quadruples my work.
Yes it's very hard to escape the impression that the big derm mills do this for $$$.