The Journal of the American Academy of Dermatology published a viewpoint on 10 October 2026 examining the ethics of delegating Mohs micrographic surgery reconstruction to non-physician clinicians.

Authors Richard Li, Yaniel Ramirez, Lauren Stone, Timothy Klufas, Albert E. Zhou, Carli Tucci, David P. Beynet, Kristen Lo Sicco and Jane M. Grant-Kels frame the piece around a widening question in procedural dermatology: as advanced practice providers take on larger roles in surgical care, where should the specialty draw the delegation line when the reconstructive step follows cancer clearance?

Why does Mohs reconstruction raise a distinct ethical question?

Mohs micrographic surgery pairs staged tumor excision with same-session reconstruction, so the operator who clears the cancer typically designs and executes the repair. Splitting those steps across clinicians — physician performs the excision, non-physician performs the closure — changes the continuity of care and the accountability structure around a skin-cancer procedure.

The viewpoint situates the issue within the growth of non-physician involvement in dermatologic surgery and asks what standards of training, supervision and patient disclosure should apply when the reconstructive component is delegated.

What does the article address?

The analysis by Li and colleagues covers the ethical dimensions of the delegation gap in Mohs reconstruction, including the responsibilities that accompany each phase of the procedure. The authors draw on their positions across dermatology and dermatologic surgery to weigh the professional obligations involved when reconstruction moves to non-physician hands.

The piece appears in JAAD, the specialty's flagship journal, which gives the discussion a reference point for practices and institutions developing delegation policies. Grant-Kels, the senior author, has a long record in dermatologic ethics and pathology, and the author group spans both surgical and ethical expertise.

Why now?

The publication lands as practices nationwide expand team-based surgical models and as payers and regulators scrutinize supervision and scope-of-practice rules. A journal-level treatment of the delegation question gives practices a citable framework for internal policy rather than ad hoc decisions about who closes which defects.

The full viewpoint, available online as of 10 October 2026, is likely to inform upcoming discussions on training pathways, supervision standards and informed-consent language for Mohs reconstruction performed by non-physician clinicians.