Study: Physician assistants less accurate in diagnosing early skin cancer
A five-year study of more than 20,000 patients who underwent screenings at UPMC-affiliated dermatology offices found physician assistants are more likely than dermatologists to perform unnecessary biopsies to check for skin cancer.
The study led by Dr. Laura Ferris, an associate professor of dermatology at the University of Pittsburgh, also found a lower detection rate by PAs for early stage skin cancer. But, both PAs and dermatologists had similar detection rates for invasive melanomas and non-melanoma skin cancer, more serious types of the disease.
“I wanted to look at the bigger picture,” said Ferris, whose study was backed by the National Institutes of Health. “Dermatology is one of the biggest users of physician assistants. The role of the PA has evolved from physician’s assistant to independent practitioner.”
Physician assistants are increasingly employed by dermatology practices to cut costs and improve access to care, the study said.
The study, published last week, in JAMA Dermatology , looked at the medical records of 33,647 skin cancer screening examinations between 2011 and 2015. In every case of melanoma that was diagnosed, a PA needed to biopsy 39 lesions, while a dermatologist needed to biopsy a little more than 25 lesions.
“PAs have far less experience and are erring on the side of caution,” Ferris said.
The study, however, said the trend of using PAs in dermatology practices is likely to continue in the future because they are being acquired by private equity firms that need to maximize shareholder profits. This, in turn, means dermatologists who use PAs must take the responsibility of training, supervising and monitoring the quality of care.
“I thought this information is important for patients to know,” Ferris said. “PAs and dermatologists are not interchangeable. The reason we screen for cancer is to find it earlier and increase the survival rates.”
Suzanne Elliott is a Tribune-Review staff writer. She can be reached at email@example.com or Twitter@41Suzanne.