By Joe Gorelick, MSN, FNP-C

With a physician shortage threatening patient care across the US, allowing physician associates/assistants (PAs) and nurse practitioners (NPs) to practice at the “top of their license” is the solution to ensuring patient safety, argues a recent commentary at

“Neither observation nor research supports the notion that expanding scope of practice for physician assistants will hurt patients,” writes Nicole Wadsworth, DO, FACOEP, FACEP, Dean of New York Institute of Technology’s College of Osteopathic Medicine. She says allowing NPs in New York to practice at the top of their license, “was a boon for patients, healthcare facilities, and overworked doctors alike.” She wants to see a similar expansion of PAs’ scope.

Dr. Wadsworth counters claims that expanding scope of practice for PAs and NPs is a threat to patient safety. PAs have 2-3 years of Master’s level education, clinical training, and experience, she notes. A “sick patient who can’t see a doctor for weeks or months would surely be safer if they could see a nurse practitioner or physician assistant right away,” Dr. Wadsworth writes.

A second, unrelated commentary also published this month asserts that the closure of Walmart Health is a signal that the US healthcare system needs more dermatology NPs and PAs. Writing in Dermatology Times, Michael Rubio, PA-C, vice co-chair of the Society of Dermatology Physician Assistants Communication Committee, cites a claim that 60% of patients with skin diseases in the US are managed by dermatology NPs, PAs, or non-dermatology MDs. He says that expanding the use of PAs and NPs trained in dermatology will close the care gap and even suggests derm NPs and PAs could be employed in primary care.

“These trusted and licensed professionals are adept at managing frontline dermatological conditions and can perform essential procedures within the primary care setting, which private equity-backed dermatology clinics have heavily relied on for scaling,” Mr. Rubio writes.

Proper training and education are essential to improve patient outcomes. The Dermatology Education Foundation, a 501(c)(3) organization, is dedicated to improving patient care by providing the highest level of dermatology education for NPs and PAs.