SweatSolutions.org: Physician Assistants Becoming Integral to Hyperhidrosis Care

May/June 2010 Edition Table of Contents:

» New Pediatric Hyperhidrosis Clinic, First of Its Kind

» Summer's Here: We've Got Sweatin' on our Minds

» Hyperhidrosis Teaching Seminars Benefit Patients Most

» Physician Assistants Becoming Integral to Hyperhidrosis Care

» View Events

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Physician Assistants Becoming Integral to Hyperhidrosis Care

If you go the doctor�s office with any regularity, you�ve likely encountered a Physician Assistant (PA) on one your visits. PAs have been around since the 1960s and are found in almost every medical specialty, from family medicine to general surgery to dermatology.

PAs are highly trained, licensed healthcare professionals who treat and diagnose patients, perform various medical procedures and act as a liaison with all members of the healthcare team, including the insurance companies. PAs always work under the supervision of a partnering doctor.

Amongst the many changes occurring in US healthcare today, PA positions are a positive and fast-growing trend. Today PAs handle much of the day-to-day workload in a medical practice, allowing their partnering physicians to concentrate on more complicated cases while still being available for consultation.

Within the hyperhidrosis community, dermatology PAs are practicing in more and more offices. Here is a first-rate example of how PAs are positively affecting the delivery of healthcare to patients with excessive sweating.

Larissa Franchuk has worked as a PA for nearly six years in the offices of world-renowned dermatologist and IHHS�s founding board member, David Pariser, MD at Pariser Dermatology. She is one of four PAs in the practice and works with several physicians in three different office locations. The practice has five offices that service the entire Hampton Roads, Virginia area.

Her list of duties is diverse and integral to the delivery of excellent dermatological patient care. �I diagnose, treat and manage a patient�s care in partnership with my supervising physician. I also perform many minor procedures, including injection of Botox for hyperhidrosis and cosmetic use, injection of cosmetic fillers, biopsies and other minor surgical excisions.�

(On a special note, Larissa recently published a review article in the Journal of Dermatology for Physician Assistants (Spring 2010, Vol. 4 No. 2), which is the journal of the Society of Dermatology Physician Assistants. Her review article concerns a study we've covered in this newsletter: "Hyperhidrosis increases the risk of cutaneous infection: a case control study of 387 patients.")

As many in the hyperhidrosis community know or have experienced, the path from discovery (learning that it's a treatable medical condition) to treatment is usually not a direct one. Obtaining hyperhidrosis care is often a challenge. One area of care that is persistently difficult to work through is obtaining insurance coverage. Franchuk�s ability to help her patients in obtaining coverage is an excellent example of the invaluable role PAs are playing in hyperhidrosis care.

She explains, saying �Effective treatment for most of our hyperhidrosis patients requires Botox injections. This is a procedure that is not reimbursed at a high rate. Additionally, it can take many man-hours to get these patients through the insurance approval process. If you then add the time it can take to perform the procedure on the patient, the cost/benefit ratio for the practice may be small. If a practice has a PA that can perform the procedure, it can become much more cost effective."

Franchuk is dedicated to her patients, and works hard to ensure that those with hyperhidrosis find relief from their condition. �I feel that this is such an important service to offer these patients; they often come in desperate for help. Most have suffered years of embarrassment over their condition. We have the opportunity to truly make a large, positive impact on their lives. I can honestly say that these are some of the most grateful patients in our practice.�

These rewarding reflections are held by many who treat patients with excessive sweating. Dr. Pariser has said it best, "Treating hyperhidrosis leads to greater improvement of a patient's quality of life than treatment of any other dermatologic disorder."

The IHHS is watching and working diligently to ensure that hyperhidrosis sufferers are not forgotten during this significant period of change in US healthcare system. Our community is fortunate to have our dermatology PAs--like Larissa Franchuk-- on the front line of patient care fulfilling their first and foremost role: delivering the best care to their hyperhidrosis patients.