Prescription Predictor Clotrimazole-Betamethasone Dipropionate Prescription, OR (95% CI)a

aphysicianandphysicianassistantwereseenduring1.4% ofthesevisits,andaphysicianassistantwasthesolehealth care provider during 0.9% of visits. Inmultivariatelogisticregressionanalysesofclotrimazole-betamethasone prescriptions, primary care providers prescribed clotrimazole-betamethasone at a rate of 4.9% compared with the dermatologist prescription rate of0.2%;othersubspecialtyphysiciansprescribedthedrug at a rate of 1.7%. Clotrimazole-betamethasone was more likelytobeprescribedatvisitstophysicianassistants(regardless of specialty) when the physician assistant was the sole provider of dermatologic care vs when the physician assistant was under direct supervision by a physician(oddsratio[OR],4.3;95%confidenceinterval[CI], 0.7-25.6 vs OR, 1.8; 95% CI, 0.4-8.0) (Table 2). The highest rate of clotrimazole-betamethasone use, 16.9%, was by physician assistants practicing in primary care and seeing patients without direct supervision. Physician assistants practicing under dermatologists and seeingpatientswithoutdirectsupervisionprescribedclotrimazole-betamethasoneatamuchlowerrateof3.8%compared withtheirprimarycarecounterparts.Forbothprimarycare physician assistants and dermatology physician assistants, however, seeing patients under physician supervisiondecreasedtherateofclotrimazole-betamethasoneprescription to 8.3% and 1.1%, respectively. Comment. Physician assistants practicing in a dermatology office are much less likely to prescribe clotrimazolebetamethasone than are physician assistants working in primary care specialties. Even without direct supervision, dermatology physician assistants’ clotrimazolebetamethasoneprescribingbehaviorisnoworsethanthat ofprimarycarephysicians.Whensupervisedbyadermatologist, physician assistants’ clotrimazole-betamethasone prescribing behavior comes closer to that of the dermatologists.