Brett Coldiron, MD
I think you’ll see more nurse practitioners and physician assistants who profess to specialize in dermatology. Right now, there’s about 6,000. I’d say that in seven years, you’ll see 10,000.
By 2020 there will be more large dermatology groups and more dermatologists employed by large multispecialty groups, at lower incomes. Many young dermatologists will belatedly realize they have signed poor contracts that pay for their productivity based on work relative value units, not realizing that practice expense relative value units comprise 2/3 of dermatology RVUs.
The specialty will further its concentration in surgical dermatology in response to the skin cancer epidemic and aesthetic dermatology in response to stagnant payment for medical dermatology.
I think you’ll see fewer dermatology residencies. I would expect you’ll see a cut of 30 or 40 percent in the number of residency slots. The remaining dermatologists will be utilized even more, and the academic programs in some of the larger cities will be forced to merge. I believe Mount Sinai just merged with a couple of the residencies in New York. It’s already happening.
In seven years you’ll see a year of medical school cut out, which I think is a good idea, and maybe even cut a year of residency out. You’ll see less training, because the bar is lowered when an NP can go out after seven years and practice like a doctor.