QSeven reasons why dermatology is the best specialty for a PA/NP

Ok, I may be biased, but I really love what I do! After starting my PA career with a general medicine foundation in emergency medicine, I made the transition to dermatology, where I hope to stay. The US Bureau of Labor and Statistics projects a 31% growth for PAs from 2020 to 2030.  According to the NCCPA, PAs in dermatology have seen a growth rate of 11.8% compared to growth for PAs in all other specialties combined at 7.6% between 2013 and 2018. So, what gives? What exactly is so great about dermatology?

1. Work-life balance. Dermatology is a specialty with excellent hours. Many clinics have regular office hours that do not include nights, weekends, or emergency call. Many clinics allow PAs and NPs to create their own schedules as long as they are generating enough income to the practice. Did you know that a recent interview study of 13000 physicians showed that dermatologists are reported to have the happiest marriages compared to other specialties only after otolaryngology, allergy, and immunology? 
2. Excellent pay! Currently, the AAPA ranks dermatology as the #2 highest-paying specialty, second to cardiothoracic surgery.
3. Dermatology for a PA/NP may include many diverse opportunities, including caring for medical, surgical, and cosmetic patients. Alternative subspecialties may include pediatric dermatology, dermatopathology, clinical trials, aesthetic dermatology, and Mohs surgery. Dermatology provides options for providers who are interested in performing surgical procedures regularly.
4. Burnout is low. According to a 2022 report on physician burnout, the highest reported specialty associated with burnout was emergency medicine at 60%, followed by critical care medicine and OB/GYN. The lowest specialties associated with burnout included dermatology at 33%, only above public health and preventative medicine. 
5. Relationships are fostered in dermatology. I enjoy forming and maintaining relationships with my patients. Skin cancer requires close monitoring and regular screening exams. Many chronic skin diseases are incurable, and treatment also requires regular visits.  Due to the frequency of these visits, rapport is established and relationships are formed. 
6. Dermatology is a very rewarding specialty. One of my favorite patient populations to treat is teenagers, specifically those with severe scarring acne. Watching a patient on isotretinoin go from withdrawn and depressed to confident and happy is truly a joy. Finding a skin cancer on a patient who would not have otherwise spotted it could literally save a life. New drugs in dermatology have provided previously impossible-to-treat skin conditions clinical clearance, which can be life-changing.
7. Dermatology requires you to “see” the problem. As a “visual learner,” this has truly been an asset to my practice. Conversely, if the patient’s skin problem is not currently present, I ask them to make sure they take pictures and come in when it’s visible. If I cannot see it, I make the patient laugh by saying, “I am sorry, but I am very superficial; I am only skin-deep!”

References:

1. Kohloff, S.  The Top Ten Highest Paying Specialties in the PA Profession in 2021.  June 8, 2022.  Accessed 1/11/2023.  https://www.aapa.org/news-central/2022/06/the-top-10-highest-paying-specialties-in-the-pa-profession-in-2021/
2. Juball, K.  Updated 2022. Top 10 Most Competitive Specialties in Medicine.  September 11, 2022.  Accessed 1/11/2023.  https://medschoolinsiders.com/medical-student/most-competitive-specialties/
3. Wilkens, K.  The PA Salary:  Structures and Strategies.  August, 2012.  Accessed 1/11/2023.  https://practicaldermatology.com/articles/2012-aug/the-pa-salary-structures-and-strategies
4. Bagget, S., Martin, L.  Medscape Dermatologist Lifestyle, Happiness, and Burnout Report 2022.  February 18, 2022.  Accessed 1/11/2023. https://webcache.googleusercontent.com/search?q=cache:BlJtBmVruyQJ:https://www.medscape.com/slideshow/2022-lifestyle-dermatologist#22