Dermatologists Delegate Cosmetic Procedures Less Frequently than Non-Dermatologist Physicians
In 2013, dermatologists performed a total of 1.8 million neuromodulator toxin procedures, more than 900,000 soft tissue filler injections, 500,000 chemical peels, 450,000 laser hair removal procedures, and 2.25 million other laser/light energy procedures. In addition to members of the traditional core cosmetic surgery specialties, members of other specialties, such as internal medicine and general surgery (among others) are now also performing such procedures.
A recent study published in Dermatologic Surgery aimed to clarify how often physicians delegate many of these cosmetic procedures to non-physician providers (NPP), such as nurse practitioners (NP), physician assistants (PA), registered nurses (RN), medical assistants (MA), and aestheticians. The study also looked at which procedures are most often delegated, and the precise qualifications of those being delegated to.
After surveying physician members of the American Society for Dermatologic Surgery (ASDS), the American Society for Aesthetic Plastic Surgery (ASAPS), and the American Society for Laser Medicine and Surgery (ASLMS), the authors found that 55.9% of dermatologists reported delegating cosmetic procedures compared with 73.8% of nondermatologists. Dermatologists were more likely to delegate chemical peels, neuromodulator and filler injections, laser hair removal, pulsed dye laser, tattoo removal, intense pulsed light, nonablative fractional laser, and sclerotherapy to higher level NPP such as NP or PA. There was no difference in level of care delegation between the 2 groups for microdermabrasion, ablative fractional laser, cryolipolysis, radiofrequency skin tightening, focused ultrasound skin tightening, or focused ultrasound fat reduction.
Plastic surgeons were significantly overrepresented in the non-dermatologist category, and the results detected may not be applicable to other specialists who took the survey.
When asked about their motivation to delegate, 45.1% delegated to increase personal income, 52.7% delegated to improve patient care, and a majority of respondents (91.4%) delegated to improve practice efficiency.
By: Wendy Meltzer, MPH
Adapted from the original article.
[image by Nguyen Hung Vu]