J Clin Aesthet Dermatol. 2024;17(11–12 Suppl 1):S28
by Kasey D’Amato, PA-C, MPAP, and Kathryn Werner, PA-C
Ms. D’Amato is President of Certified PA Consulting in Ft. Lauderdale, Florida. Ms. Werner is Practice Owner, Senior Business Consultant, Certified PA Consulting in Ft. Lauderdale, Florida.
FUNDING: No funding was provided for this article.
DISCLOSURES: All authors are employees of Certified PA Consulting.
Introduction
With the large number of procedures and higher risk, dermatology and aesthetics are not the first specialties that come to mind when I think of telemedicine or even a physician assistant (PA)-owned practice. However, as we began to see during the COVID-19 pandemic, many dermatological and aesthetics visits can be successfully completed via telemedicine, making dermatology and aesthetics yet another exciting area where PAs can enter practice ownership through telemedicine. For PAs hoping to expand into procedure-based care, starting a telemedicine practice initially can be a way to enter ownership more quickly, establish marketing and a patient base, and grow an income, all of which can be leveraged into a physical practice.
Low Barrier to Entry
One of the most appealing aspects of establishing a teledermatology practice is the low barrier to entry. Unlike traditional brick-and-mortar practices, telemedicine requires minimal startup costs. Eliminating the need for a physical space while using telemedicine platforms to decrease the administrative costs makes startup costs reasonable for PAs.
Conditions Suitable for Telemedicine
While many conditions are not appropriate for telemedicine, there are many that are. Acne, rosacea, eczema, psoriasis, skin cancer screening, and skin care consultations are all appropriate for telemedicine. There is the possibility of doing cosmetic consultations where a PA could discuss treatment options for injectables, laser treatments, and other cosmetic procedures that would best match a patient’s treatment goals. While it wouldn’t be possible to do the actual procedures virtually, patients often feel more confident in receiving information from an unbiased provider with medical data.
Conducting an Exam via Telemedicine
Most of us were not trained to conduct a physical exam virtually, but with some creativity, or training, it is possible to get much of the information we get in person virtually. With appropriate instruction, most patients are usually capable of assisting in the exam. Some specific techniques for a virtual dermatologic exam include:
Use a coin placed by the patient alongside the rash or lesion to provide size comparison.
Use a transparent cup or bottle to press against the skin to check for blanching.
Use alcohol swab (if available) to check for terra firma forme dermatosis
There are also specialized dermatoscopes that can be used by a trained provider at a distant site and transmitted. This could be an excellent way to partner with primary care providers, establish relationships, and reach more patients.
Unique Opportunities in Teledermatology
One of the most exciting parts of PA practice ownership is being able to be creative in your approach to medicine. In working with PA entrepreneurs in any specialty, we think about how we can create a practice they love working in, that their patients love being a part of, and that generates a healthy income. Ideas like:
Offering asynchronous skin care consultations with product recommendations
Partnering with skincare companies or even creating an Amazon storefront as an added stream of revenue
Partnering with local primary care providers to provide skin cancer screenings to remote areas (because I know very few primary care folks who just love skin cancer screening!) with the hope they refer for other conditions
Partnering with local aesthetic providers or spas for patients needing higher levels of care.