John Notabartolo DMSc, PA-C discusses Tips and Tricks as a Dermatology PA
In this video
In this interview with Carrie, John Notabartolo walks through hands-on tools he considers indispensable. He explains how the eyelid clamp — an instrument most people associate with ophthalmology and chalazion surgery — has "a myriad of uses" in dermatology, giving density and control anytime you're working on spongy tissue that "is gonna run away from you." He uses it for torn earlobe and gauge repairs, tongue and lip biopsies like a mucous cyst, and lesions on the genitalia. He also describes covering periocular milia or small skin tags with a plastic otoscope cap so liquid nitrogen can be focused precisely without damaging peripheral tissue — a step up from waiting on cotton-tipped applicators.
John closes with a topic he calls "of utmost importance," especially in a specialty with the potential for litigious patients: carrying your own medical malpractice policy. When a practice says it covers you, he warns, they typically add you as a rider on the physician's or group's policy — and the insurance company's job is to protect the policyholder, not you, which can mean a settlement is allowed to go against the PA to keep the physician's name clear. He endorses the AAPA member liability policy he carries himself for roughly $2,500 to $3,000 a year.
- Keep an eyelid clamp on hand for any spongy, mobile tissue — earlobe repairs, tongue and lip biopsies, and genital lesions — where it adds density and keeps tissue from running away from your blade or punch.
- Cover periocular milia or small skin tags with a plastic otoscope cap to focus liquid nitrogen precisely and spare the surrounding tissue.
- Don't rely on your employer's malpractice coverage: being a rider on the physician's or group's policy means the insurer protects the policyholder, not you.
- Carry your own liability insurance so someone is actually looking out for your interest in a lawsuit — John endorses the AAPA member policy at about $2,500–$3,000 a year.
