A Physician Assistant (PA) is a licensed medical professional who undergoes rigorous education and training to practice medicine as part of a healthcare team. These clinicians are educated at the master’s degree level and are authorized to diagnose illnesses, develop treatment plans, and perform medical procedures under the direction of a supervising physician. Minor surgical procedures, such as the evaluation and removal of skin lesions like moles, are common in dermatological practice and frequently fall within the PA’s scope of expertise. The ability of a PA to perform these tasks is determined by their specialized training, the delegated authority of their supervising physician, and state regulations.
Professional Authorization for PAs
Physician Assistants are authorized to perform minor surgical procedures, including mole removal, provided the task is delegated by their collaborating physician and is consistent with state medical board rules. This authorization is granted through a formal practice agreement that outlines the specific medical services the PA is permitted to perform. In dermatology, this often includes the full spectrum of in-office procedures for lesions, such as biopsies and excisions.
The PA’s scope of practice is determined by the laws of the state in which they are licensed. PAs function as physician extenders, capable of performing procedures within the supervising physician’s scope of practice and the PA’s demonstrated competence. This structure allows PAs to manage routine dermatological conditions efficiently. Delegation relies on the PA’s comprehensive medical education and any supplemental specialty training.
Assessing Moles and Removal Techniques
Before any removal takes place, a PA is trained to conduct a detailed assessment of the mole for suspicious characteristics. This involves a clinical evaluation looking for features suggesting potential malignancy, such as asymmetry, irregular borders, color variation, or a diameter larger than six millimeters. Based on this initial examination, the PA determines the most appropriate course of action, which may be observation or a removal procedure.
PAs commonly perform three types of mole removal procedures in the clinical setting. A shave biopsy removes a raised lesion flush with the skin using a fine scalpel blade, often used for benign or superficial moles. For lesions requiring deeper sampling, the PA may perform a punch biopsy, which uses a circular tool to remove a small, full-thickness core of tissue. Simple excision involves cutting out the entire mole and a small margin of surrounding skin, necessitating sutures to close the wound.
The Role of Physician Supervision
The practice of a Physician Assistant is defined by a collaborative relationship with a supervising physician, which is a regulatory requirement in every state. This collaboration does not always require the physician to be physically present or on-site while the PA performs a procedure. Instead, supervision typically means the physician is readily available for consultation, either in person or through telecommunication, to review complex cases or complications.
The degree of oversight is formally established in a written collaborative practice arrangement. This arrangement outlines the physician’s responsibilities for chart review and interaction frequency. In some jurisdictions, there may be specific geographic limits on the distance between the supervising physician’s primary location and the satellite office where the PA works. This framework ensures that while the PA maintains autonomy in routine care, the physician remains responsible for the overall oversight of the patient’s treatment.
Knowing When to See a Specialist
While PAs are highly proficient in performing routine mole removals and biopsies, certain scenarios necessitate an immediate referral to a dermatologist or a surgical specialist. Any mole highly suspicious for melanoma—a severe form of skin cancer—requires the diagnostic expertise and advanced treatment planning of a physician specialized in dermatology. The complexity of the lesion’s appearance or the need for a specialized procedure like Mohs surgery is a clear boundary for the PA’s scope.
Moles located in cosmetically or functionally sensitive areas, such as the face, hands, or areas near joints, often require a specialist referral. These excisions may demand complex reconstructive techniques to minimize scarring and preserve function, skills typically possessed by a dermatologist or plastic surgeon. The PA’s role in these situations is to recognize the complexity of the case, ensure patient safety, and facilitate a timely referral to the appropriate expert for the best outcome.