Ethics of utilizing nurse practitioners and physician's assistants in the dermatology setting.

Our current supply of dermatologists in training is insufficient to meet the growing demand for dermatology services. In an era of declining reimbursements and the ever increasing clamor for increased access to care, many practices are turning to nurse practitioners and physician assistants as a cost effective means of fulfilling patient demand. Despite the recommendations of the American Academy of Dermatology, there is no explicit consensus among dermatologists on the educational requirements or appropriate utilization of NPs and PAs in dermatology settings. Colleges of nursing and physician assistant programs recognize the provider demand in dermatology and have begun to implement training programs to address the need for specialty training. Academic settings offer a unique opportunity for NPs and PAs to receive a medically oriented grounding in basic science, dermatopathology, and research.