by Renata Block, DMSc, MMS, PA-C
Ms. Block is with Rush University in Chicago, Illinois.
Introduction
Rural and underserved communities face a critical shortage of primary healthcare, exacerbating the emergence of “dermatology deserts”—areas with limited or no access to specialized skin care. This gap in care compounds existing health disparities, leaving patients with untreated skin conditions that can significantly impact their quality of life. To address this crisis, physician assistants (PAs) and nurse practitioners (NPs) are stepping up as vital providers, leveraging their training and flexibility to deliver essential dermatology services.
The Role of PAs and NPs in Bridging the Gap
PAs are foundationally trained to serve underserved populations, with a fast-track education of under four years designed to address physician shortages. Similarly, NPs are increasingly filling critical voids in healthcare delivery, particularly in rural areas. Both PAs and NPs are equipped to practice primary care or specialize, with many choosing dermatology to meet the growing demand for skin care in these regions. Their ability to provide high-quality, accessible care is crucial in combating dermatology deserts.
The versatility of PAs and NPs allows them to adapt to the unique needs of underserved communities. By focusing on dermatology, they address a wide range of conditions, from common issues like eczema to complex cases such as skin cancer, which often go undiagnosed in areas lacking specialists. Their presence not only improves access to care but also reduces the burden on primary care providers, who might lack the expertise to manage dermatologic conditions.
Building a Collaborative Dermatology Community
The dermatology community is more connected than ever, thanks to the internet and organizations such as the Rural Access to Dermatology Society (RAD). These platforms enable NPs and PAs to collaborate with colleagues nationwide, discuss challenging cases, and participate in tailored educational meetings. Such engagement fosters a robust network that enhances patient care by sharing knowledge and resources specific to rural and underserved areas.
NPs and PAs help to form the backbone of dermatology care in these regions, working alongside physicians to create an integrated framework for patient management. By connecting with peers through organizations like RAD, they ensure that even the most isolated providers have access to support and expertise, ultimately improving outcomes for their patients.
Community Outreach and Education
Beyond clinical care, dermatology NPs and PAs play a critical role in community outreach and education. Many skin conditions are misunderstood or overlooked, leading patients to delay seeking care. By educating the public about skin diseases and promoting the availability of specialized care outside primary care offices, NPs and PAs empower communities to take charge of their health.
However, effective care requires collaboration with primary care providers. NPs and PAs must proactively introduce themselves to local clinics, offering information and support to alleviate concerns about managing complex dermatologic issues. By fostering trust and open communication, they can establish comanagement models that ensure seamless care for patients with skin conditions.
The Power of Interdisciplinary Collaboration
The best patient outcomes arise from interdisciplinary collaboration, not only within dermatology, but also across specialties such as cardiology, gastroenterology, and rheumatology. NPs and PAs, alongside MDs and DOs, bring unique skill sets to the table. By working together, they create a holistic approach to care that addresses both dermatologic and systemic health needs.
Comanagement is particularly vital in underserved areas, where resources are scarce, and patients often present with multiple comorbidities. By leveraging each provider’s expertise, the healthcare team can deliver comprehensive care that improves individual outcomes and strengthens community health overall.
Below are some actionable recommendations for NPs and PAs to address dermatology deserts in rural and underserved areas:
- Specialize in dermatology. Pursue additional training or certification in dermatology to meet the critical need for specialized skin care in underserved regions. Focus on conditions prevalent in these areas, such as skin cancer or chronic dermatoses.
- Join professional networks. Engage with organizations such as RAD to connect with colleagues, share knowledge, and discuss challenging cases. Participate in virtual meetings or forums to stay updated and supported.
- Conduct community outreach. Organize educational workshops or campaigns to raise awareness about skin diseases and the availability of dermatology care outside primary care settings. Use patient-friendly materials to empower communities to seek timely treatment.
- Build relationships with primary care providers. Proactively reach out to local primary care clinics to introduce yourself, share expertise, and offer support for dermatologic cases. Establish referral pathways to streamline patient care.
- Foster interdisciplinary collaboration. Partner with specialists in fields like cardiology or rheumatology to comanage patients with complex conditions. Share insights and coordinate care to ensure holistic treatment plans.
- Leverage technology. Use telehealth platforms to consult with patients in remote areas and collaborate with other providers. Utilize online resources for case discussions and continuing education to enhance skills.
- Advocate for policy support. Work with professional organizations to advocate for policies that expand NP and PA scope of practice in underserved areas, ensuring greater access to dermatology care.
A Shared Commitment to Patient Care
Whether an MD, DO, NP, or PA, all healthcare providers share a common goal: to improve the lives of their patients. In dermatology deserts, NPs and PAs are indispensable in making this vision a reality. Through their training, dedication, and collaborative spirit, they are addressing the shortage of care, educating communities, and building networks that enhance access to vital services.
By continuing to connect, collaborate, and advocate for underserved populations, dermatology NPs and PAs are not only filling critical gaps but also paving the way for a healthier, more equitable future. This is the essence of why we all entered medicine—to work together for the betterment of our patients and communities.