• Molly B Austin, Divya Srivastava, Ira H Bernstein, and Jeffrey S Dover.
• Departments of *Dermatology, and †Biostatistics, University of Texas Southwestern, Dallas, Texas; ‡Department of Dermatology, SkinCare Physicians, Boston, Massachusetts.
• Dermatol Surg. 2015 Jul 1; 41 (7): 827-32.

BackgroundHow delegation of procedures varies among cosmetic specialties in the United States is not well described.ObjectiveTo better describe current practices in delegation of procedures to nonphysicians among physicians of different cosmetic specialties in the United States.MethodsAn 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).ResultsA 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.ConclusionDermatologists delegate procedures to NPP less frequently than non-dermatologist physicians, and when they do, it is typically to higher level NPP.

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