Brad Glick, DO, MPH: Advanced Practice Practitioners in Modern Dermatology Care

Brad Glick, DO, MPH

The Fall Clinical Dermatology 2023 Conference for PAs & NPs kicked off in Orlando, FL this weekend, the first of a series of advanced practice practitioner-targeted meetings offered by dermatology organizations this month. The agenda items covered in these now annual meetings reflect the ever-evolving role of these care team members in the overall screening, diagnosis and care of patients in dermatology practice—with topics ranging from best practice efficacy to emerging systemic therapies in atopic adermatitis.

In an interview with HCPLive leading up to the Fall Clinical, Brad Glick, DO, MPH, dermatologist with Glick Skin Institute and assistant clinical professor of dermatology at the Herbert Wertheim College of Medicine at Florida International University, discussed the changing role of advanced practice practitioners both in his practice and in the general field of dermatology, as well as the value of meetings such as this weekend’s.

HCPLive: With regard to a litany of matters—dermatology becoming more and more burdened by chronic disease, rising patient populations, improved diagnostics requiring improved referral and care teams—what does the advanced practitioner's role ideally look like to you in the field?

Glick: Well, I think advanced practice practitioners play a critical role in our day-to-day practice, and I say that from a team perspective. Dermatology is very busy specialty; the dynamics of our practices are changing, we're taking care of different and more challenging diseases, and there's a challenge to set timely appointments. So, having advanced practice practitioners as part of our practices—and I have 2 that work in my clinic, and my daughter is actually a dermatology PA—I think that they play a very important role in the access story in dermatology, so that we really get patients into our practice, and that they receive exceptional care from these individuals who partner with us in the collaborative care that we can provide for our patients.

HCPLive: With regard specifically to the unique roles: the sentiment we hear a lot is that direct patient interaction—that first encounter of not just dermatology patients, but future dermatology patients—generally is delivered from the advanced practitioner. Do you feel there's a pretty clear distinction of the responsibility of advanced practitioners playing that patient-fronting role, to initiate the process of care?

Glick: I do, and I think that that dynamic has changed so much in the last 3 years—especially since the pandemic, the need for each individual to participate collaboratively with us in caring for our patients has become perhaps more critical than ever. But I say this also with the optic of complete collaboration with supervision, and that we work as a care team.

I think that there's 2 different approaches: I may see someone initially, and then partner up with one of the advanced practice practitioners in my group, in a collaborative effort for ongoing care. In the same token, some patients, when I'm in the clinic with my physician assistant, and we have a patient that needs to be seen urgently, the schedule is very busy, one of the things that they have really complete confidence in is that we can get that patient into the clinic in a very timely manner. They're seen promptly by our advanced practice practitioner in our group, and then I jump in, and we really work together on finding the best treatment plan after appropriate assessment for this individual.

HCPLive: Each of Derm Fall Clinical for PAs + NPs, Maui Derm for NP + PA Summer 2023, and SDPA Summer 2023 are occuring this month. With each, there seems to be an emphasis on the discussion of prescribing strategies, especially as it relates to new and emerging systemic therapies, biologic agents, and unique pathway-targeting inhibitors.

Can you share perspective on the physician's role in leading prescribing strategy discussions and new guideline information to this care team?

Glick: I think that's a really great question. Keeping with what I said a couple of minutes ago about the last 3 years and the advancement of the role of the advanced practice practitioner in our clinical practices: I'm very hybrid. I have some educational teaching residents, we advanced practice practitioners in our practice—but I think at the university level too, and our larger institution, we see that the roles of nurse practitioners and physician assistants have become more critical, more a part of that care team, and I think is an extension of what I was saying before. It's really created the necessity for more education for that group of healthcare practitioners.

And I think you highlighting that there's this converging of all these different meetings that provide education for advanced practice practitioners—some by advanced practice practitioners or for many of us who are also providing some of this education—it really is inclusive not only of disease state, diagnosis, and treatment of dermatologic diseases at least in our space, but also the therapeutics which have been really important of late because we have so many new therapies.

You know, psoriasis is an example as an area where I think our advanced practice practitioners over this last 10 years have had a really nice provision of education in that area. There are some disease states that have just had no therapies for the longest period of time—for alopecia areata, atopic dermatitis, vitiligo—and I think it's been really critical in these last few years, not only for us as physicians to receive this information, but also to extend that educational opportunity to our advanced practice practitioner partners that are working in our in our clinics. And that is conveyed by the convergence, as you said, of these very important meetings that are occurring this summer.