Do Physician Assistants Give Less Accurate Melanoma Diagnoses Than Dermatologists?

Physician assistants have significantly contributed to patient health services by reducing long dermatology appointment wait times and lowering clinical costs. However, according to a recent study conducted by University of Pittsburgh School of Medicine research, physician assistants have a less accurate melanoma diagnosis rate than dermatologists.

The group of researchers led by Laura Ferris MD, PhD, looked at 33,647 skin cancer screening exam records from 2011 to 2015 that took place at the University of Pittsburgh Medical Center. They found that PAs were less likely to diagnose melanoma in situ than dermatologists. However, both types of clinicians had even detection rates for invasive melanomas and nonmelanoma skin cancers, which, according to EurekAlert, “are often more clinically obvious.”

The study also determined that PAs biopsied more than 39 pigmented lesions per melanoma case, whereas dermatologists only needed to biopsy just over 25 lesions. This means that PAs only correctly assessed one out of every 39 possible melanoma cases, and dermatologists’ accuracy rate was of one out of 25.

Ferris said that the study findings should prompt healthcare providers to consider their financial priorities. "In the age of cost-conscious medicine, it's important to consider more than just a clinician's salary," she said. "Missed diagnoses or unnecessary biopsies of benign lesions should be factored into decisions about the scope of a practice, hiring decisions, supervision of providers and patient decisions about who provides their dermatologic care."