I have been going to my dermatologist office for 16 years and have never seen the actual derm MDs or DO. Are the NPs or PAs more qualified? You can argue, but they definitely dont have as much training and exposure to skin issues. Doctors in derm are so competitive the best ones should have done research. NPs and PAs I noticed are not as versed and detailed in their diagnosis and treatment plans.

Most patients dont know the difference and thus just trust the PA and NP. Ive had pretty negative experience with mine and my severe eczema. As a teenager I didnt know better and just accepted their prescriptions for steroids and listened to their same shit spiel about avoiding soaps, detergents and blah blah. It took a long time before they even brought up Dupixent.

Its truly about diet, gut health, and supplements. I learned more about eczema, bacteria, and remedies from people on Reddit than I did with these providers. If you have major issues and arent happy with them you should request seeing the actual physicians.