title: A Survey Comparing Delegation of Cosmetic Procedures Between Dermatologists and Nondermatologists.
abstract: BACKGROUND
  How delegation of procedures varies among cosmetic specialties in the United States is not well described.
  
  
  OBJECTIVE
  To better describe current practices in delegation of procedures to nonphysicians among physicians of different cosmetic specialties in the United States.
  
  
  METHODS
  An Internet-based survey was administered to physician members of the American Society for Dermatologic Surgery (ASDS), the American Society for Aesthetic Plastic Surgery (ASAPS), and the American Society for Laser Medicine and Surgery (ASLMS).
  
  
  RESULTS
  A total of 823 responses were collected. Two hundred ninety-one of the 521 dermatologists (55.9%) reported delegating cosmetic procedures compared with 223 of the 302 nondermatologists (73.8%) (p < .05). When delegation occurred, dermatologists were more likely than nondermatologists to delegate the following procedures to higher level non-physician providers (NPP): chemical peels, neuromodulator and filler injections, laser hair removal, pulsed dye laser, tattoo removal, intense pulsed light, nonablative fractional laser, and sclerotherapy. No difference in delegation rate was noted between dermatologists and non-dermatologist physicians with respect to microdermabrasion, ablative fractional laser, cryolipolysis, radiofrequency skin tightening, focused ultrasound skin tightening, and focused ultrasound fat reduction.
  
  
  CONCLUSIONS
  Dermatologists delegate procedures to NPP less frequently than non-dermatologist physicians, and when they do, it is typically to higher level NPP.
authors.affiliation: Departments of *Dermatology, and †Biostatistics, University of Texas Southwestern, Dallas, Texas; ‡Department of Dermatology, SkinCare Physicians, Boston, Massachusetts.
authors.forename: Molly B
authors.initials: MB
authors.lastname: Austin
authors.forename: Divya
authors.initials: D
authors.lastname: Srivastava
authors.forename: Ira H
authors.initials: IH
authors.lastname: Bernstein
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Dover
mesh_terms: D002983:Clinical Competence; D003357:Cosmetic Techniques / Q000592:standards*; D032022:Delegation, Professional; D003880:Dermatology; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce