Kubicki Shelby L, Wang Jordan V, Geronemus Roy G, Friedman Paul M
Department of Dermatology, McGovern Medical School at the UTHealth Science Center at Houston, Houston, Texas, USA.
Laser & Skin Surgery Center of New York, New York, New York, USA.
Clin Dermatol. 2023 Mar-Apr;41(2):257-261. doi: 10.1016/j.clindermatol.2023.06.009. Epub 2023 Jul 3.
A rising demand for dermatologic procedures has led to a recent increase in the number of non-physician operators (NPOs) in the dermatology workforce. Nurse practitioners, physician assistants, and aestheticians commonly perform procedures in both physician-based practices and medical spas with varying degrees of dermatology-specific training and physician oversight. Although the lack of regulations can negatively impact patient outcomes and adverse events, the role of NPOs in dermatology continues to grow. Among Medicare beneficiaries, nurse practitioners and physician assistants are independently billing for a growing number of dermatologic procedures, whereas the number performed by dermatologists remains relatively stable. Medical spas are an increasingly popular destination for aesthetic consumers, and the majority employ only NPOs as primary providers. Recent data suggest that compared to dermatologists, NPOs have a higher rate of adverse events. As attempts are made to standardize and improve the training requirements for dermatologic procedures, a concerted effort should be made to prioritize patient outcomes and safety.
对皮肤科手术需求的不断增加，导致近期皮肤科从业人员中非医师操作人员（NPOs）的数量有所上升。执业护士、医师助理和美容师通常在基于医师的诊所和医疗美容中心进行手术，他们接受的皮肤科特定培训程度和医师监督程度各不相同。尽管缺乏监管可能会对患者预后和不良事件产生负面影响，但NPOs在皮肤科领域的作用仍在不断扩大。在医疗保险受益人中，执业护士和医师助理独立计费的皮肤科手术数量越来越多，而皮肤科医生进行的手术数量相对保持稳定。医疗美容中心越来越受美容消费者欢迎，大多数中心仅将NPOs作为主要服务提供者。最近的数据表明，与皮肤科医生相比，NPOs发生不良事件的比率更高。在努力规范和提高皮肤科手术培训要求的过程中，应齐心协力将患者预后和安全放在首位。
