A Retrospective Analysis of Trends in Non-physician Provider Billing in Dermatologic Surgery From 2016 to 2019

Abstract

www.mohscollege.org/for-physicians/acms-fellowship-training. Accessed December 14, 2021. 5. Coldiron BM. Should we pursue board certification in Mohs micrographic surgery? Available at: https://www.mdedge.com/dermatology/article/113747/should-we-pursue-board-certification-mohs-micrographic-surgery. Accessed December 14, 2021.

Trends and Distribution of Dermatologic Procedures Performed by Dermatology Nonphysician Clinicians in the Medicare Population, 2015 to 2019

“…1 Although a recent Medicare analysis identified increased rates of repairs, flaps, destructions, and removals by all NPCs, the extent to which this was driven by NPCs in other procedural specialties was unclear. 2 Nonphysician clinicians also demonstrated a notable increase in several specialized complex procedures, which is important given they have less formalized procedural training than dermatologists.…”

“…Female Dermatology Residents Have Inadequate Access to Well-Fitting Surgical Gloves at Training Centers I ll-fitting surgical gloves adversely affect manual dexterity and may impede development of surgical skills. 1,2 In the authors' experience, sterile glove sizes at the poles of the spectrum, particularly smaller sizes, are often unavailable in dermatologic surgery clinics. This may lead to sex disparities in surgical training.…”

“…1 Although a recent Medicare analysis identified increased rates of repairs, flaps, destructions, and removals by all NPCs, the extent to which this was driven by NPCs in other procedural specialties was unclear. 2 Nonphysician clinicians also demonstrated a notable increase in several specialized complex procedures, which is important given they have less formalized procedural training than dermatologists. Although optional dermatology credentialing is now offered for nurse practitioners and physician assistants through their respective societies, sitting for these examinations requires 3,000 to 4,000 hours of practice experience in dermatology without specific procedural requirements.…”

“…Thus far, studies have suggested inferior biopsy sensitivity rates and potentially greater adverse events from cosmetic procedures by NPCs. 2,5 The reason for differing NPC procedural volume by practice setting cannot be fully elucidated, but should motivate better characterization of practical, didactic, and instructive training opportunities in both groups.…”

“…Nonphysician clinicians (NPCs) have expanded their practice presence within dermatology, performing more skin biopsies and increasingly complex procedures. 1,2 Although this may expand access, there are a lack of standardized training and education guidelines for NPCs in dermatology. We reviewed Medicare data to better clarify procedural use among NPCs actively involved in dermatology.…”