Use of Physician Assistants in Mohs Micrographic Surgery: A Survey of Fellowship-Trained Mohs Micrographic Surgeons MARK A. HYDE, MMS, PA-C, Ã MICHAEL L. HADLEY , MD, y CONRAD ROBERSON, MBA, MED, Ã ABBY JACOBSON, MS, PA-C, z LISA PAPPAS, MSTAT , y AND GLEN M. BOWEN, MD y BACKGROUND An increasing number of dermatologists are using physician assistants (PAs) in their practices. A lack of information regarding the use of PAs in Mohs micrographic surgery (MMS) served as the driving force for this research. OBJECTIVES To quantify the extent to which Mohs surgeons are using PAs in MMS. METHODS Five hundred seventy-six fellows of the American College of Mohs Surgery were sent surveys in the mail in January 2009. The survey was focused on what percentage of Mohs surgeons are using PAs and how those PAs are being used. RESULTS One hundred forty-three of the 576 surgeons surveyed (24.8%) responded; 43 of those (30.1%) currently employed one or more PAs; and of those 43, 15 (34.9%) reported that PAs in their practice perform preoperative consults, 25 (58.1%) reported that PAs perform postoperative follow-up, 18 (41.9%) reported that PAs were participating in some aspect of repairs, and 35 (81.4%) reported that PAs were seeing general der- matology patients. CONCLUSION Mohs surgeons are using PAs for perioperative care, as well as seeing general derma- tology patients. A smaller percentage of Mohs surgeons are using PAs to perform portions of MMS or the consequent repairs. The authors have indicated no significant interest with commercial supporters. M ohs micrographic surgery (MMS) has been shown to be an effective treatment for nonmelanoma skin cancers, with relatively low morbidity. The technique limits the removal of healthy tissue while maintaining a low recurrence rate. 1 This is accomplished using an intraoperative evaluation of nearly 100% of the surgical margins, a simple mapping technique, and the fact that the surgeon and the pathologist are one and the same. We wanted to explore the role and use of physician assistants (PAs) in MMS and consider whether increasing the surgeon’s efficiency would increase patient access to this specialized level of care. MMS is a technique developed in the 1940s by Dr. Frederick Mohs requiring the skills of a derma- tologist, dermatopathologist, and reconstructive surgery specialist. Fellowship-trained Mohs surgeons undergo extensive training to achieve the high levels of accuracy necessary to remove skin cancers and achieve excellent cosmetic and functional results while maintaining acceptable recurrence rates. 2 The nature of the procedure and the extent of the training required raises the question as to which portions of the procedure may be safely delegated to PAs. The use of PAs in MMS has not been quantified, nor have the specific tasks being performed by PAs been identified. Although Resneck and Kimball have somewhat delineated the activities of these provid- ers, 3 we sought to gather data on what percentage of & 2010 by the American Society for Dermatologic Surgery, Inc.  Published by Wiley Periodicals, Inc.  ISSN: 1076-0512  Dermatol Surg 2010;36:1700–1703  DOI: 10.1111/j.1524-4725.2010.01721.x 1700 Ã Melanoma and Cutaneous Oncology, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah; y Department of Dematology, University of Utah, Salt Lake City, Utah; z Dermatology Associates of Lancaster, Lancaster, Pennsylvania; and y Biostatistics Core, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah.