"Dr. Jay Herbst of Port Charlotte, Fla., has two words of advice for his fellow dermatologists who are trying to make a living in the era of managed care:  physician assistants.

"Because of Medicare cuts and insurance changes, we have to see more patients, and we spend less time with each one," he said. "Having a physician assistant allows us to return some of that time to the patient. PAs are the best kept secret in dermatology."  Dr. Herbst, who specializes in skin cancer surgery, is among a growing number of dermatologists and other physicians who are hiring PAs to help increase their patient base. Since hiring PA Joe Santini 2 years ago, Dr. Herbst has seen a 50% increase in patients."

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