Original article
The dermatology work force: A focus on urban versus rural wait times

https://doi.org/10.1016/j.jaad.2008.09.008Get rights and content

Background

Recent studies suggest a shortage of dermatologists with an average wait time of 36 days in the United States and 40 days in Ohio for a routine dermatology visit. To date, no previous studies have examined supply and demand of dermatology services in rural versus urban populations.

Objective

We sought to determine the average wait time for a dermatology appointment for new and established patients in both urban and rural areas.

Methods

The offices of 250 dermatologists in Ohio were contacted by telephone to determine the wait time for the next available appointment for new and established patients with a changing mole.

Results

The average wait time for new (4.5 weeks) and established (3.1 weeks) patients was similar to times reported in previous studies. A greater density of all dermatologists and medical (general) dermatologists practice in cities, but wait times were not statistically different in rural versus urban settings.

Limitations

Neither insurance status or use of physician extenders were considered. The findings may not be applicable to areas outside Ohio.

Conclusion

There is a shortage of medical dermatologists throughout Ohio. Training more medical dermatologists or adding physician extenders to dermatology practices would be expected to decrease the waiting time for dermatology appointments. Providing incentives for dermatologists to practice in underserved rural areas may not be necessary judging by the similarities in wait times between rural and urban settings.

Section snippets

Methods

In November 2007, a list of 319 board-certified dermatologists from Ohio was obtained from the American Academy of Dermatology (AAD) World Wide Web site that includes data on 96% of dermatologists practicing in the United States.11 Using a uniform script, telephone calls were made to each of the 319 dermatologist's offices in Ohio by a single person (E. U.) posing as a new patient with a changing mole to determine the wait time until the next available appointment. A second telephone call was

Results

Using 2005 US Census Bureau data and the list of 319 dermatologists from the AAD World Wide Web site, there are 2.8 dermatologists per 100,000 people in Ohio.14, 15 Of the 319 dermatologists, only 250 practice medical dermatology whereas 69 dermatologists were excluded from our analysis for various reasons (Fig 2). Of the 250 practicing medical dermatologists, 6.8% were not accepting new patients at the time of the study.

The average wait time was 4.5 weeks and 3.1 weeks for a new and

Discussion

The wait times for an urgent dermatologic problem in this study are similar to wait times for routine appointments reported in other studies (average range 36-40 days). These data suggest that the current number of dermatologists in Ohio (2.8 dermatologists/100,000 population) is inadequate to meet the public need.4, 5, 6, 7 Excluding specialty dermatologists and those not in active practice, only 2.2 dermatologists per 100,000 population are available to provide care for a patient with a

References (23)

  • Society of Dermatology Physician Assistants. SDPA membership. Available from: URL: http://www.dermpa.org/#/Home/....
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    Funding sources: None.

    Conflicts of interest: None declared.

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