By Michael H. Gold, MD, FAAD, board-certified dermatologist and founder of Gold Skin Care Center Published October 21, 2026
Key takeaways
Physician assistants (PAs) and nurse practitioners (NPs) are licensed medical providers who examine patients, diagnose conditions, prescribe medicine, and perform procedures.
A dermatologist is a physician who completed medical school and a dermatology residency. PAs and NPs are not dermatologists, and a good practice is clear about the difference.
At Gold Skin Care Center, our PAs and nurse practitioner work under my medical direction, and I am involved in complex cases.
Licensed aestheticians provide med spa treatments such as facials and peels. They are not medical providers and do not diagnose or prescribe.
When you book a dermatology appointment, you may see a physician assistant (PA) or nurse practitioner (NP) rather than the dermatologist. That is normal in modern dermatology, and it is often how practices keep appointments available for patients who need to be seen soon. What matters is that you know who you are seeing, what their training is, and how the physician is involved in your care.
I have led Gold Skin Care Center as its only physician since I founded it in 1990, and I have worked with PAs and NPs for much of that time. Patients sometimes ask me, quietly, whether seeing a PA or NP means they are getting second-best care. The honest answer depends on the practice. Here is how it works, and how it works at ours.
What a dermatologist is
A dermatologist is a medical doctor (MD or DO) who has completed medical school, an internship, and a dermatology residency, and who treats conditions of the skin, hair, and nails in people of all ages. A board-certified dermatologist has also passed the certification exams of a dermatology board, such as the American Board of Dermatology. The letters FAAD after a dermatologist's name mean they are a Fellow of the American Academy of Dermatology; the AAD explains what FAAD means.
I am a board-certified dermatologist and dermatologic surgeon, and a Fellow of the American Academy of Dermatology.
What a physician assistant does
Physician assistants are licensed medical providers trained in the medical model. According to the American Academy of Physician Assistants, PA programs are master's-level, typically about 27 months long, and require around 2,000 hours of clinical rotations and a national certification exam. The "C" in PA-C means the PA is certified.
The AAPA notes that PAs take medical histories, perform exams, diagnose and treat illness, order and interpret tests, develop treatment plans, prescribe medication, perform procedures, and take part in clinical research. Exactly what a PA does depends on their experience, their specialty, and state law.
In dermatology, a PA may see patients for acne, eczema, rashes, skin checks, and many other concerns, and may perform procedures such as biopsies.
What a nurse practitioner does
Nurse practitioners are registered nurses who have completed advanced graduate education. The American Association of Nurse Practitioners explains that all NPs complete a master's or doctoral degree program and advanced clinical training, and that they diagnose and treat conditions, order and interpret tests, and prescribe medications and other treatments. NPs are board-certified in a population focus, such as family, adult-gerontology, or pediatrics.
Some NPs earn a Doctor of Nursing Practice (DNP), the highest clinical degree in nursing.
PA or NP vs. dermatologist: what is different
The key difference is the depth and length of specialty training. A dermatologist spends years in a residency devoted to skin disease. A PA or NP in dermatology builds that expertise on the job, which is why the physician's involvement matters.
How our team works at Gold Skin Care Center
Gold Skin Care Center is a physician-led practice. I am the practice's dermatologist and medical director. Our clinical team includes board-certified physician assistants and a board-certified nurse practitioner, and they diagnose, treat, and prescribe under my medical direction. Tennessee law sets the framework for how PAs and NPs practice alongside physicians, and we work within it. When a case is complex, unusual, or not responding as expected, we talk it through together.
The team you may see includes:
Marci Levy Kleinrock, PA-C, a board-certified physician assistant who specializes in medical, surgical, and aesthetic dermatology. She serves as a sub-investigator on dermatology clinical trials, has authored peer-reviewed publications, and helps train physician assistant and nurse practitioner students.
Rachel Eckert, PA-C, a physician assistant who trained at Trevecca Nazarene University and is a member of the Society of Dermatology Physician Assistants.
Collette Utley, DNP, NP-C, a Doctor of Nursing Practice and board-certified nurse practitioner who holds both family and pediatric nurse practitioner credentials. Her doctoral work focused on atopic dermatitis, which is especially helpful for families managing eczema in children.
You can read each provider's full background on our providers page.
What about aestheticians?
Our Advanced Aesthetics Medical Spa is staffed by licensed aestheticians who provide treatments such as facials and dermaplaning and chemical peels. Aestheticians are skin care professionals, not medical providers. They do not diagnose conditions or prescribe medicine, and their work at our practice takes place under physician oversight. If an aesthetician notices something that needs a medical look, such as a changing mole, they will recommend a medical appointment.
Questions to ask at any dermatology practice
Whether you come to us or go elsewhere, these questions help you understand who is caring for you:
Who will I see, and what is their credential? You should always know whether you are seeing a physician, PA, NP, or aesthetician.
Is there a board-certified dermatologist at the practice, and how involved are they? Ask how the physician supervises or collaborates with the rest of the team.
What happens if my condition is complex or not improving? A good answer involves the physician.
Who performs procedures such as biopsies, surgery, injectables, and lasers? Credentials and training should match the procedure.
The AAD's guide on how to select a dermatologist is another good resource.
What to do next
Review our team's credentials on the providers page.
If you have a preference about who you see, mention it when you schedule.
Call (615) 383-2400 or use our scheduling form. New to the practice? Read our guide to your first dermatology appointment.
Frequently asked questions
Is a PA or NP a doctor? PAs and NPs are licensed medical providers, not physicians. Some NPs hold a Doctor of Nursing Practice degree, which is a doctoral degree in nursing, not a medical degree.
Can a PA or NP do a skin cancer check? Yes. Full-body skin exams are a routine part of dermatology PA and NP practice, and concerning spots can be biopsied and reviewed with the physician as needed.
Can I request to see Dr. Gold? You can ask when you schedule. Our front desk can explain availability and which provider is the best fit for your concern.
Do PAs and NPs prescribe medication? Yes. PAs and NPs can prescribe, within the scope that state law allows.
This article is for general education and is not medical advice. Results vary, and every treatment carries risks. An appointment with a board-certified dermatologist or qualified dermatology provider is the best way to learn which options are right for you.
About the author
Michael H. Gold, MD, FAAD, is a board-certified dermatologist and dermatologic surgeon and the founder and medical director of Gold Skin Care Center in Nashville, which he established in 1990. He also founded the Tennessee Clinical Research Center and holds appointments as Clinical Assistant Professor at Vanderbilt University School of Nursing and Adjunct Assistant Professor at Meharry Medical College School of Medicine. Read Dr. Gold's full bio.
