SANTA MONICA, CALIF. Without question, a physician assistant can inject welcome cash into a cosmetic dermatology practice, as evidenced by the $516,000 in income generated by Krystie P. Lennox in a recent 6-month period at an aesthetic center in Boca Raton, Fla.
Ms. Lennox believes, however, that the full measure of a PA's worth should be gauged in hours, not dollars. "One of the primary benefits to hiring a PA in aesthetic medicine is the luxury of time: taking an extra 5 minutes with patients to make the experience [different] from those clinicians who 'turn and burn' their patients," she said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation.
PAs can decrease waiting times, increase the number of services offered, and enhance patient safety by allowing for more follow-up visits. They can also bring to aesthetic medicine the art of "service, service, service," a business priority advocated by author Jack Mitchell in his book, "Hug Your Customers" (New York: Hyperion Press, 2003).
Paraphrasing the author, Ms. Lennox said, "It is no longer enough to satisfy customers. You have to develop extremely satisfied customers."
By positioning the PA as a highly trained professional with the time and desire to build a warm, personalized rapport with patients, a busy dermatologist may see dividends in terms of patient comfort and staff enthusiasm, she said.
PAs "must prove to patients that not only do they want to treat themselves to the botulinum toxin or dermal filler in this office, but also they want the PA to perform the treatment," said Ms. Lennox, a certified physician assistant who works with Dr. David Goldberg, a dermatologist, and Dr. Jason Pozner, a plastic surgeon, in Boca Raton. "The M.D. is critical in this handoff," she noted.
Team building begins with how the PA is introduced to the staff and how he or she is accepted and promoted by them. One helpful step in the process is to ensure that staff members receive cosmetic treatments from the PA, perhaps during live demonstrations, to enhance trust and rapport.
"A patient will speak with the receptionist on the phone and at the check-in counter, and likely will see the medical assistant and the physician before the first interaction. If any of those people hesitate in the slightest manner, the chance of patient conversion [to a PA cosmetic patient] drops dramatically," said Ms. Lennox.
The supervising physician should introduce established patients to the PA, and should voice confidence in his or her training and ability.
The introductory period may be an opportune time for a 15%-25% rise in physician fees for cosmetic services while the PA's charges remain at previous levels, thus offering patients an incentive to try the PA. This frees the physician to focus on techniques of special interest and difficult cases.
A physician assistant also can spend time at seminars, courses, and conferences, learning specialized and state-of-the-art cosmetic procedures for patients who want to stay on the cutting edge, Ms. Lennox said.
Admission to conferences is sometimes restricted to physicians; however, Ms. Lennox is one of the organizers of a meeting specially designed for PAs and nurse practitioners (www.aestheticextendersymposium.com
Currently, there are more than 68,000 PAs in clinical practice in the United States. They wrote more than 303 million prescriptions in 2007, approximately 17 million more than the year before.
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