Our Providers
Currently, Bridge Dermatology is a boutique practice owned and operated by Dr. Ryan M. Trowbridge. In 2026 due to rapidly growing demand, Dr. Trowbridge brought on his long-time physician assistant, Tessa Farnham, to assist with patient care. Learn more about Dr. Trowbridge and Tessa below!
Dr. Ryan M. Trowbridge, MD, MS, MA, FAAD
I am a board certified dermatologist in both general dermatology and micrographic dermatologic surgery. I was born and raised in Connecticut and spent the first 25 years of my life there. I completed my undergraduate training at Yale University, my post-baccalaureate training at Fairfield University, a Masters degree at Boston University, my medical degree and an additional Masters degree at Creighton University, and finally completed my dermatology residency training at Harvard University from 2014-2018.
​
I started Bridge Dermatology largely out of frustration with how dermatology is typically practiced: long waits, quick visits, and little communication. My mission is to provide a new standard for the delivery of dermatologic care by providing convenient, comprehensive, and technologically advanced skincare.
​
As a doctor, my approach to the practice of medicine is to be evidence-based but open-minded. I acknowledge that we don’t know everything, and that even things we think we know now may one day prove to be incorrect. The best we can do is to evaluate the body of knowledge that exists and make the best decision given the information available.
​
However, that is becoming harder and harder to do. The sheer volume of information available to the average person is undigestible on his or her own. Furthermore, identifying what is fact and what is fiction, especially with the power of social media to contend with, is a daunting task. It is, frankly, sometimes hard to know who and what to believe. My hope is that with Bridge Dermatology I will be able to deliver, at the very least, honesty and transparency to the process of managing your skin issues.​
​
During my dermatology residency I was heavily involved in medical photography. What I came to realize is that I could often times discern more from a quality photograph of a skin issue than I could with the naked eye. I was also bothered by patients dealing with long waits to get into a dermatologist, sometimes receiving numerous ineffective treatments, potentially incurring side effects, all for something that could have been addressed in a few minutes had someone been able to send a good picture.
​
After residency, I practiced dermatology in a traditional setting and continued to experience many of the same as well as other frustrations with how our patients experience dermatologic care. But when I met the founders of Miiskin in 2021, I began to envision a better way of practicing dermatology. Bridge Dermatology is where we will realize that vision and bring our patients the experience they deserve!
Tessa Farnham, PA-C, CAQ-Derm
OUR PARTNERSHIP
Tessa has worked with me (Dr. Trowbridge) for nearly 5 years now. For the first 2 years, Tessa saw EVERY patient I saw. We thought this was important so she could develop the expertise that I have gained over years of intense specialty training and practice. To this day, Tessa and I work side by side in clinic, never more than a few feet apart. Although she sees many of her patients without my involvement, our close proximity allows us to collaborate whenever it is needed. This ensures every patient who is seen by either Tessa or me gets the highest level of expert care, never compromising because of lack of knowledge or training. In fact, we think this team approach is even better than getting care by a single dermatologist or doctor as you have 2 dedicated specialists working on your case whenever needed - it is like a built in second opinion.
If interested in how Physician Assistants are trained and why Tessa is so unique among her colleagues, you can read more below.
​​
WHAT EXACTLY IS A PHYSICIAN ASSISTANT?
​Many people have heard of a Physician Assistant (PA), but the majority probably don't know what one is or what training they have. Established in the 1960s, the Physician Assistant (PA) role was designed to extend primary care services under direct physician (aka, doctor) supervision, to give highly trained physicians like dermatologists a way to reach more patients with their expertise. However, over decades, PAs have been used more as revenue extenders than care extenders. Unfortunately, under the pressure to increase access and boost revenue, I think many "supervising" physicians have opted to have PAs seeing more patients on their own faster, to increase the throughput of patients and procedures in their medical practice. This is very different with how Tessa and I operate.
​
A PA IS NOT A DOCTOR...BUT THEY CAN BE JUST AS HELPFUL IF TRAINED PROPERLY
After a medical student becomes a doctor, he or she will complete at least 4,000–5,000 hours of supervised mentorship by expert, fully trained dermatologists over a period of 3 years (called a "residency"). It is only after that training that they are able to take the dermatology boards and become a board-certified dermatologist (doctor/MD with specialty training in dermatology.
In contrast, many states like my home state of Nebraska have NO REQUIREMENT for training of PAs in a specialty prior to delivering dermatology care to patients. After completing 26 months of PA school (a little more than half of what a medical student completes in medical school), what they require is only 80 hours of "supervision" before a PA can see patients independently. Furthermore, this initial supervision isn't even direct supervision - the supervising doctor merely needs to be "available" if he or she is needed. It is simply impossible to become competent in a specialty like dermatology with this little initial training.
​
So how well-trained is your PA? Well, that is the problem. There is no standard way of knowing. There is a major gap in standards and best practices dictating how much training a PA needs in dermatology before seeing patients independently (pubmed.gov/38047888). Anecdotally, many PAs in outpatient specialties like dermatology receive 3 months or less of true, residency-level supervision, and often much less.
​
So WHEN AND WHY SHOULD I SEE A PHYSICIAN ASSISTANT?
PA training is different than medical doctor training in that there is a primary focus on clinical skills. This results oftentimes in PAs being more clinically skilled than freshly graduate doctors. But remember, doctors then go on to 3-7 years of continuing apprenticeship before becoming fully autonomous doctors.
​
If considering seeing a PA, ask the following 2 questions:
1) "How long did you spend seeing patients alongside your supervising doctor before seeing patients alone?"
2) "How available is your supervising doctor if we needed his or her assistance or expertise?"
If the answer is anything less than 6 months, be very careful about what type of experience you are getting. Ideally, a PA should spend 1-2 years with a supervising physician collaborating on the majority if not all the patients seen over that time period. ​​
And, if the supervising provider is not available in person or at the very least by phone at all times, this also should raise questions about how invested the PA-doctor team is in providing you the best possible care in all scenarios.