What is the future of Dermatology?

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I am a current US medical student who is in love with derm. However, I am a bit anxious about future job security of the specialty and would like to know what you all think of my reasoning.

The first issue I see is increasing scope of practice from mid-levels. There are several nurse practitioners near me that own entire practices with not a single physician employed. Looking through the lists of services offered it appears no different from a clinic that is staffed with dermatologists. They do everything from botox injections to diagnosing and removing skin cancer. While people make the argument that someone will always prefer to see a doctor, in real life I see that many patients don't even notice that the provider seeing them is not an MD or DO. If mid levels can also provide these services for lower prices, I am struggling to see how this isn't bad news for the future of dermatology.

The second issue is AI. Yes, I am aware that folks have been preaching the end of several jobs from the dawn of the personal computer, but it is difficult to ignore how rapidly AI is advancing. There are numerous startups who have the very specific goal of developing devices and software to diagnose skin conditions. Yes, these technologies are likely a ways away, but I will need a job for at least the next 30 years. The argument I hear against this is that companies will not want the liability and will always want a dermatologist to check the work. Yes, this may be true, but how many dermatologists are needed to do this?

While I do not believe that dermatologists will become completely obsolete in my lifetime, I do think that these two factors will heavily impact job security and compensation.

I really hope that I am wrong and there are flaws in my reasoning. What do you all think?

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The midlevel only practices are just trying to skim off easy eczema and cosmetics. They aren’t useful for patients that need a real dermatologist imo (and experience with my own patients who need a dermatologist). This is bad news for derm because this will dilute the easy cases to break up the tough ones. But there will be a need for actual dermatology conditions because the midevels don’t want these. TLDR: midlevels want to play dermatologist for easy lucrative appts. They can’t replace a real dermatologist.
 
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I am a current US medical student who is in love with derm. However, I am a bit anxious about future job security of the specialty and would like to know what you all think of my reasoning.

The first issue I see is increasing scope of practice from mid-levels. There are several nurse practitioners near me that own entire practices with not a single physician employed. Looking through the lists of services offered it appears no different from a clinic that is staffed with dermatologists. They do everything from botox injections to diagnosing and removing skin cancer. While people make the argument that someone will always prefer to see a doctor, in real life I see that many patients don't even notice that the provider seeing them is not an MD or DO. If mid levels can also provide these services for lower prices, I am struggling to see how this isn't bad news for the future of dermatology.

The second issue is AI. Yes, I am aware that folks have been preaching the end of several jobs from the dawn of the personal computer, but it is difficult to ignore how rapidly AI is advancing. There are numerous startups who have the very specific goal of developing devices and software to diagnose skin conditions. Yes, these technologies are likely a ways away, but I will need a job for at least the next 30 years. The argument I hear against this is that companies will not want the liability and will always want a dermatologist to check the work. Yes, this may be true, but how many dermatologists are needed to do this?

While I do not believe that dermatologists will become completely obsolete in my lifetime, I do think that these two factors will heavily impact job security and compensation.

I really hope that I am wrong and there are flaws in my reasoning. What do you all think?
Midevels don't need to worry about all that silly malpractice insurance, so they are emboldened to take on things they should really be referring for. Once enough mistakes are made and money is lost (lawyers and admins wya), the general public will realize that there is a massive difference in care between doctors and midlevels and elect to see the former.
 
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Midevels don't need to worry about all that silly malpractice insurance, so they are emboldened to take on things they should really be referring for. Once enough mistakes are made and money is lost (lawyers and admins wya), the general public will realize that there is a massive difference in care between doctors and midlevels and elect to see the former.
We hope so… but I’ve been saying that for 10 years. It’s only getting worse in that timeframe.
 
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I am a current US medical student who is in love with derm. However, I am a bit anxious about future job security of the specialty and would like to know what you all think of my reasoning.

The first issue I see is increasing scope of practice from mid-levels. There are several nurse practitioners near me that own entire practices with not a single physician employed. Looking through the lists of services offered it appears no different from a clinic that is staffed with dermatologists. They do everything from botox injections to diagnosing and removing skin cancer. While people make the argument that someone will always prefer to see a doctor, in real life I see that many patients don't even notice that the provider seeing them is not an MD or DO. If mid levels can also provide these services for lower prices, I am struggling to see how this isn't bad news for the future of dermatology.

The second issue is AI. Yes, I am aware that folks have been preaching the end of several jobs from the dawn of the personal computer, but it is difficult to ignore how rapidly AI is advancing. There are numerous startups who have the very specific goal of developing devices and software to diagnose skin conditions. Yes, these technologies are likely a ways away, but I will need a job for at least the next 30 years. The argument I hear against this is that companies will not want the liability and will always want a dermatologist to check the work. Yes, this may be true, but how many dermatologists are needed to do this?

While I do not believe that dermatologists will become completely obsolete in my lifetime, I do think that these two factors will heavily impact job security and compensation.

I really hope that I am wrong and there are flaws in my reasoning. What do you all think?
Agree that derm job market will likely become more saturated in the next few years for the reasons mentioned above, as these factors will reduce demand for dermatologists overall. This will also tend to drive down pay and possibly increase workload for those who already have a job to make the same amount of money. Also if residency slots continue to expand, at least the good news will be that derm won't be the hyper competitive specialty to match into that it has always been and more USMD med schools with more average apps will be able to match into it.
 
Outlook mostly good despite some challenges. You will have to be fairly entrepreneurial if you want to make really good money though, go toe to toe with those NP practices that I can guarantee have thriving social media presence and marketing.

Truth is any idiot can do a decent Botox injection - I’ve even let med students inject me before. A lot of other cosmetic treatments are similarly simple. It’s fairly hard to screw up, though possible. So those cushy private derm practices face competition from not only midlevels but also dentists and other MDs who want to grab a little of that cash pay business. Ditto for selling your own line of overpriced beauty products - also lots of places doing this too.

If you could develop a similar passion for Mohs surgery and do a fellowship, you’d have a lot more security in a very lucrative niche of the market while also having your derm board cert. Something like that would offer you some nice options.
 
All specialties are going to be heavily saturated with AI and states allowing foreign doctors to practice without doing residency so might as well just choose what you like
 
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Agree that derm job market will likely become more saturated in the next few years for the reasons mentioned above, as these factors will reduce demand for dermatologists overall. This will also tend to drive down pay and possibly increase workload for those who already have a job to make the same amount of money. Also if residency slots continue to expand, at least the good news will be that derm won't be the hyper competitive specialty to match into that it has always been and more USMD med schools with more average apps will be able to match into it.
When I can get a patient in to see a dermatologist in less than 4 months within an hour radius, then I'll believe the job market is anything approaching concerning
 
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AI and pattern recognition....

I mean, its fine to dismiss, but it's real... (time stamp 3:30)


Maybe many of you don't realize, but 20 years ago.... we had flip cell phones.


AI in medicine is a good thing. Idk why people are afraid. Most docs are not even technologically sound enough to even use it aways...
 
AI in medicine is a good thing. Idk why people are afraid. Most docs are not even technologically sound enough to even use it aways...
Because most people with 400k in loans and over a decade of opportunity cost don’t want to be unemployed
 
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