NP/PA independent practices bill a majority in one specialty...

[sazerac]

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derm! http://archderm.jamanetwork.com/article.aspx?articleid=1895673

Yes there are some caveats like they only counted medicare billings, the only counted procedures that had more than 5,000 billings, etc. But out of all the possible medical specialties out there, they bill more often for derm procedures than for all other specialties combined.

This may reflect a an attitude of "follow the money" by midlevel providers. It may also reflect the huge demand by patients for derm services that simply isn't being met by the existing physician dermatologist framework.

The conclusion of the article is also interesting. Instead of pushing for training more dermatologist physicians to meet patient demand, or being grateful that these midlevels take the bread-and-butter cases and leave the complicated cases for physicians, the authors suggest a third approach.

 

[DermViser]

Midlevels want good lifestyle and high pay or just good lifestyle. No surprise they're going for fields like Derm, GI, etc. Derm as a specialty has no control to ask for more Medicare dollars to be spent on residents, esp. since hospitals control that allocation and thus want to spend it on inpatient services (for now).

 

[Psai]

From my own personal experience, mid levels seem to be woefully unprepared for providing dermatologic services. It's a very difficult thing to look at a lesion on the skin, determine what it is and decide what to do. It doesn't surprise me that they are going for that field though, I would too if I were in their shoes

 

[DermViser]

From my own personal experience, mid levels seem to be woefully unprepared for providing dermatologic services. It's a very difficult thing to look at a lesion on the skin, determine what it is and decide what to do. It doesn't surprise me that they are going for that field though, I would too if I were in their shoes

They're a great source of revenue for inadvertent referrals, due to their f-ups.

 

[Elisabeth Kate]

From my own personal experience, mid levels seem to be woefully unprepared for providing dermatologic services. It's a very difficult thing to look at a lesion on the skin, determine what it is and decide what to do. It doesn't surprise me that they are going for that field though, I would too if I were in their shoes

My experience was exactly the opposite. I needed to get in to see a derm and the only one available at the practice I usually went to was a PA. She was wonderful and actually made me respect PAs a lot. I continued to go to her whenever I had a derm problem or concern before I moved for residency.

 

[styphon]

Midlevels are human, and specifically human Americans - so not surprisingly they have the same motivation as most Americans(even doctors) - MONEY.

Although the NP and PA increase in numbers/schools/independence was suppose to help PMD - the government's plan failed as they forgot people care more about money then "filling primary care gaps".

Someone had a pie chart showing where new grad PA's went, but I did not save it..

 

[DermViser]

Midlevels are human, and specifically human Americans - so not surprisingly they have the same motivation as most Americans(even doctors) - MONEY.

Although the NP and PA increase in numbers/schools/independence was suppose to help PMD - the government's plan failed as they forgot people care more about money then "filling primary care gaps".

Someone had a pie chart showing where new grad PA's went, but I did not save it..

Yet NPs are saying they'll do it as an excuse to loosen up their scope of practice.