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Provider-Related Factors Associated With an Increased Likelihood of Performing Benign Skin Biopsies
TAKE-HOME MESSAGE
- This study aimed to identify provider-related factors associated with increased odds of performing benign skin biopsies. The results showed that nurse practitioners and physician assistants were significantly more likely to perform benign skin biopsies than Doctor of Medicine/Doctor of Osteopathic Medicine physicians. Providers in Western regions and metropolitan cities were more likely to perform a greater number of benign biopsies needed to detect one malignant lesion.
- This study showed that nurse practitioners and physician assistants are more likely to perform benign skin biopsies, which may lead to greater healthcare costs, patient morbidity, and psychological distress among patients.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND AND OBJECTIVE
To identify provider-related characteristics associated with a higher proportion of benign skin biopsies.
PATIENTS AND MATERIALS/METHODS
Medicare Part B database was analyzed, and for each provider, the number of skin biopsies that he/she performed that were benign lesions was estimated.
RESULTS
Increased benign skin biopsies were performed by nurse practitioners and physician assistants (as compared to Doctor of Medicine/Doctor of Osteopathic Medicine) (odds ratio [OR] of 1.9 and 1.6, respectively), providers in the Northeast (OR 1.2), West (OR 1.2), or Midwest (OR 1.1) (as compared to the South), providers in metropolitan cities (OR 1.1), and providers in states with a higher cost of living index. Multivariable regression analysis revealed provider credentials, city size, and the West region to be significant (p < .05) factors in the number needed to biopsy to detect 1 malignant lesion.
CONCLUSION
This analysis is performed only on Medicare patients, which can limit the generalizability of the results over all the population groups. Nurse practitioners and physician assistants (as compared to Doctor of Medicine/Doctor of Osteopathic Medicine), providers practicing in the West (as compared to in the South), and providers practicing in metropolitan cities (as compared to nonmetropolitan cities) were more likely to perform benign skin biopsies than their counterparts.
Additional Info
Disclosure statements are available on the authors' profiles:
Advanced Practice Providers and Western Providers Are Associated With Increased Likelihood of Benign Skin Biopsies: A Cross-sectional Analysis
Dermatol Surg 2024 Dec 04;[EPub Ahead of Print], P Aggarwal, M DaCunha, K Rismiller, S Neltner, B Coldiron, AB FleischerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
I read this article with interest. Although, at first blush, the advanced training of dermatologists shines through compared with providers with a broader range of skills, I would like to emphasize that nurse practitioners and physician assistants should perform biopsies more frequently until they gain sufficient skills over time. The worst thing that can happen is missing a melanoma at an early stage.