Is This Right?

[KARENNN]

I have found that dermatologists here will often have a nurse or physicians assistant do the full-body check for possible skin cancer and, if they find something suspicious, then they will schedule you to see the actual MD. The RN or PA will even do the biopsy. What do you think about this? Is medical school not as important in the field of dermatology?
Appointment coming up with the highly recommended Dr. Tran...only will not get to see him unless the PA finds a problem in the initial visit.

[Mikeod]

I have routinely been examined by a PA or NP in dermatology both here and in CA. Here, if they see something suspicious, they do a biopsy, and schedule excision or other treatment if it comes back positive. I don't have to see an MD except on the day of treatment. So far, all of their suspicions have been diagnosed accurately.

These people have to be well trained and certified to perform these exams. Think about it for a minute. If you were a physician and had people working under your license, you would make sure they were competent and capable.

[blueash]

Learning to recognize what may be a suspicious lesion does not require 4 years of medical school and 4 more years of resisdency training. A PA or NP can learn to separate the benign from the suspicious just as well as an MD, and at a lower cost can see and screen patients. If the doctor had to see all the non-concerning lesions you wouldn't be seeing Dr. Tran for a long long time as that would be all he would be doing. Instead this allows the person with the highest training to be doing the more intensive work.

[batman911]

I believe that if I am paying the rate for a doctor's services, I should be seen by a doctor. I am OK with the PA doing the screening if the office rate is reduced to reflect that level of service.

[Freeda]

When my husband saw Dr. Corwin for a skin issue that happily turned out to be benign, the doctor himself did a whole body skin check. Even if the norm is that other trained staff can do this, it would be my preference for the doctor to do the skin check. His phone # 352 259 6553. (Villages office is in the bldg next to the Sharon Morse bldg).

[BigLew]

my wife recently had an appointment with a dermatologist here only to find out on arrival that despite the fact that when she made the appointment to see the DOCTOR they had taken it upon themselves to schedule her with a PA. We asked them to reschedule the appointment with the doctor we do not pay to receive care from a PA. An MD is an MD a PA is not. I have no problem with them assisting the doctor during my visit.

[VillagesFlorida]

I have found that dermatologists here will often have a nurse or physicians assistant do the full-body check for possible skin cancer and, if they find something suspicious, then they will schedule you to see the actual MD. The RN or PA will even do the biopsy. What do you think about this? Is medical school not as important in the field of dermatology?
Appointment coming up with the highly recommended Dr. Tran...only will not get to see him unless the PA finds a problem in the initial visit.

If you are seeing Philomena at Dr. Tran's you can rest assured that you will be in very competent hands. Dr. Tran's practice does not participate in my insurance now so I will not be going to the office there anymore. Dr. Tran's focus is on surgery now.

[joannej]

A lot of drs. that do Mohs surgery only see a patient after a biopsy comes back positive. I love PA's and they are very competent. I am not talking about "young" PA's. The ones I see have a lot of experience with this subject and I feel they are very qualified. Also, I point out spots for further inspection, and have biopsies done on those spots. Some times they do come back positive!

[Irishkatie]

I am a patient of Dr. Trans because they employee PAs and NPs. The PAs have their own provider number and bill under that number at 85% of the physicians allowable Medicare fee. Most commercial insurances follow that same rule. Thank you all for the positive comments on PAs. We are well trained but only as good as the doctor we work with. I was in oncology and worked with wonderful physicians. I knew my limits and never placed a patient in harms way. I developed wonderful relationships with the patients that would return year after year for their well patient check-ups which allowed my supervising physicians to see the sicker or newly diagnosed patients. It is a model that has worked well for over 40 years now and very much needed as we all live longer and have more chronic but treatable diseases.

[CMANN]

Wait until you have your first eye examination. 90% of it is conducted by technicians. They do a good job.

I guess it is just the villages way.

[Canabarrybarb]

Our first dermatologist here in The Villages would stop by to talk sports but all the work was done by his assistants. Then he would schedule you to see another assistant afterwards whose job it was to try to sell you lots of expensive lotions and creams. We quickly found another dermatologist who is much more interested in her patients.

[BigLew]

I am a patient of Dr. Trans because they employee PAs and NPs. The PAs have their own provider number and bill under that number at 85% of the physicians allowable Medicare fee. Most commercial insurances follow that same rule. Thank you all for the positive comments on PAs. We are well trained but only as good as the doctor we work with. I was in oncology and worked with wonderful physicians. I knew my limits and never placed a patient in harms way. I developed wonderful relationships with the patients that would return year after year for their well patient check-ups which allowed my supervising physicians to see the sicker or newly diagnosed patients. It is a model that has worked well for over 40 years now and very much needed as we all live longer and have more chronic but treatable diseases.

I have no problem whatsoever with PA's doing THEIR job, I do have a problem with PA's doing the doctors job, as well as with those doctors. I am a heart transplant recipient as well as having antiphospholipid syndrome there is no doctors office that I wish to step into where I am not getting my primary diagnostic work done by the physician. I have a very good relationship with the PA's at the transplant center and believe that PA's have an important place in patient care BUT when I specifically make an appointment to see the doctor I will settle for nothing less. Do you ask a mechanic about your engine problems or the guys who specialize in oil changes and filter changes??

[zcaveman]

I go to Dr Bond and he uses students and PAs. But if you do not want the students, etc, you can tell them and Dr Bond will do the entire exam. He is in the room anyway and does check their work.

He does use a PA named Scott for the surface skin cancer removals. I have never ad a problem with him and he does good work. Dr Bond uses doctors for the MOHS surgery.

I had PAs up in NJ and PAs down here as assistants to the medical doctors. Not a big problem.