Perspectives in Acadamic Dermatology Practice
The entirety of my 18-year healthcare career has been within the halls of a university-based, academic health center. I have decided to give you some insight into what I do know and share my personal experience as a dermatology nurse practitioner in a full-time academic setting.
As I reflect on my experience, the benefits of working in academia are numerous and related to knowledge acquisition, growth as a clinician, and leadership preparedness. Built-in education through weekly grand rounds or having the ability to pick the brains of dermatology “giants” by simply walking down the hall are some obvious, yet indispensable advantages. Additionally, working in a tertiary referral center has allowed me to see a number of incredibly rare and complex cases in a relatively brief period of time. Many are those that some only read about in textbooks or see once in their career lifetime. Other benefits include continuing education beyond the walls of the university. We are financially supported and encouraged to attend a number of conferences per year without limitation. Lastly, there is less pressure to see high volumes of patients and more focus cultivating and participating in the academic mission of the department. We are encouraged to promote the culture of academia through teaching, research, or engaging in leadership initiatives. Combined, these benefits create an environment that promotes and prioritizes life-long learning and evidenced-based, patient centered care.
There are pros and cons to any practice setting. The main challenge that I have experienced while working in academia involves the hierarchical environment. Physicians and resident trainees occupy the top of the totem pole in academic dermatology, often leaving everyone else to advocate for themselves. It is easy for the academic dermatology advanced practice provider to become an invisible part of the department. The growth, visibility, success, and respect of the advanced practice providers in our department has required constant and deliberate self-advocacy, promotion, conflict resolution and patience. Another challenge is compensation. Dermatologists and dermatology advanced practice providers tend to be compensated less than their private practice counterparts. Additionally, in our institution, advanced practice providers are not included in any productivity or departmental-based incentives despite our physician counterparts being included. Unfortunately, this discrepancy can lead to discouragement, burn out, and high turnover rates, encouraging academically-trained advanced practice providers to leave for private practice. Some of these drawbacks may always be present, while others, with continued advocacy may evolve as we continue to prove our worth in the dermatologic arena.
Overall, my experience in academic dermatology has been incredibly fulfilling. It is an environment where my passion for dermatology, enthusiasm for continuing education, and commitment to teaching the next generation of dermatology APP’s, can continue to develop and thrive.
Fun Fact about author: Veronica played softball from the age of 6 and was recruited by and played for the University of Pennsylvania women's softball team.
Veronica Richardson ANP-BC, DCNP is a dermatology certified nurse practitioner at the Perelman Center for Advanced Medicine at the University of Pennsylvania in Philadelphia, PA. She sees general dermatology patients and has passion for NP/PA education. Outside of work she enjoys spending time with her husband and makes a goal to develop one new hobby each year.