Essentials for Early Career Success Among Dermatology PAs, With Joseph Gatti, DMSc, MPAS, MBA, PA-C

Joseph Gatti, DMSc, MPAS, MBA, PA-C, the founder of The Clinic for Dermatology & Wellness, LLC, spoke in a Q&A interview with HCPLive at the 2025 Society of Dermatology Physician Associates (SDPA) Fall Conference in San Antonio regarding a session he had presented.1

The session Gatti had presented was titled ‘The Productive PA: Smart Scheduling & Contract Essentials for Early Career Success.’ During the talk, Gatti highlighted several helpful tips for physician associates (PAs) early in their careers, first giving his view on different perceptions of the relationship between PAs and dermatologists. The following Q&A includes Gatti’s responses.

HCPLive: What would you say are some key takeaways from your session on redefining the modern PA-dermatologist partnership?

Gatti: For the dermatologist and the PA partnership, people need to remove ego out of it and remember that it really, truly is a partnership. Over the years, I've been doing this long enough that I remember the infamous New York Times article in 2017, where the past AAD president, Dr Coldiron, basically put a hit piece out [that was] anti-PAs, and it was traumatizing. There are some physicians out there who are just like, ‘PAs are horrible,’ and let's be honest, we know that that happens.

We know that this exists, but there are just as many, or more, physicians who love working with PAs. We bring expertise and an ability to grow the practice, grow the business, but also augment patient care. We have to be honest with each other that AAD and physicians in general have not grown enough physicians, and that's multi-specialty, specialty-wide. But obviously, the demand far outstrips supply. And PAs help millions of Americans every year.

What we all have to keep in mind is that this is a partnership. It is not a competition. It's not that one is better than the other. It should be that we both bring something unique and a very unique perspective to the battlefield…We both have a part to play, and as long as we respect each other and just remember that we're here for the same goal, treat patients, cure cancer. It is not about us; it's not about our ego. It's about helping the person in front of you. As long as we focus on the relationship we have with our physicians, it will be fantastic.

HCPLive: What are your thoughts on the DMSc degree for PAs, and what advice do you have for those who are interested?

Gatti: I know there are a lot of different thoughts out there about the Doctor of Medical Science degree for PAs, the equivalent for the Doctor of Nurse Practitionership for NPs, and the AMA titles and scope creep that we've seen out there. I am a DMSC holder. I did my degree at the University of Lynchburg, and what I would tell you is this: there is significant utility for the degree in patient care, but it's very specific.

For me, for PAs and NPs, the utility of this degree is not that I can call myself a doctor, now. That's not the utility. That also depends on the state you're practicing in. Oregon does allow it; Texas does not. But that's not the utility. I actually mostly still go by Joe with my patients, because I like to be informal. The utility of it is that my specific concentration was in administrative medicine.

I'm a practice owner. I own 3 different businesses. I do consulting. I own one of the largest med spas in the Pacific Northwest, and I own a dermatology practice. For me, administrative medicine makes sense because a lot of my time outside of patient care is managing multiple businesses and all the administration that goes with it.

So to me, the benefits of these degrees are for PAs wanting to leave clinical practice or augment beyond clinical practice. They want to be a medical science liaison for one of the pharmaceutical companies or they want to get into a management position at a hospital.

For those folks, these degrees make total sense, but…for the entry-level degree, I'm 100% against it. A lot of the people who are pushing it, I'm going to be frank, are heavily biased. Most of the people in the AAPA and other organizations are also adjunct professors at all these schools that are going to benefit.

…I think PAs across the board need to realize this degree change, for the average PA, will not change their practice. If you want to be called ‘Doctor’ and you're in a state that allows it, okay, maybe. Maybe that's worth it to you. But for new PAs, what this is going to do is add tens of thousands of dollars in costs. That's the truth.

The quotes used in this Q&A summary were edited for the purposes of clarity.

Gatti had no relevant financial disclosures of note.

References

1. Gatti J. The Productive PA: Smart Scheduling & Contract Essentials for Early Career Success. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.