Long Wait List to See a Dermatologist? Botox isn’t Entirely to Blame
According to Diane Mapes, reporting for MSNBC, a study published in the Journal of the American Academy of Dermatology reports that 851 potential patients, concerned about a changing mole, were given a wait time that averaged 38 days.
In some cities, the wait time was even longer: 47 days in Syracuse, 48 in New York City, Phoenix saw a 48 day wait and Bostonians waited the longest: 73 days. What is going on here?
It’s no secret that the wait to schedule an appointment with a dermatologist has grown increasingly longer in the past few years. But the scary reality is that even patients with potentially life-threatening skin concerns, such as changing moles or freckles, are now being told to take a number and wait in line.
Many sources are to blame. Says Dr. Jack Resneck, assistant professor of dermatology at University of California, San Francisco “Dermatologists are seeing an increase in demand for everything.” This includes better treatments for psoriasis and eczema, as well as more people becoming educated about skin cancer warning signs and getting frequent skin checks. The problem is that because of a federal cap on how many medical residents can be trained each year, patient demand for appointments hasn’t been matched with an increase in doctors, especially in the field of dermatology.
In addition, the demand for cosmetic procedures continues to grow at an extremely rapid pace. One New York resident remarks that over the last decade, wait times for procedures like Botox injections have increased from a three day wait to potentially a three month wait. From the perspective of a dermatologist, it isn’t surprising that cosmetic procedures would be more alluring than other procedures. While a skin checkup goes through insurance and usually pays the doctor from $30 to $100, a typical Botox treatment is paid for at the time of service, and costing anywhere between $300 and $1,000, produces more revenue. Cosmetic procedures are also quicker, and don’t have as many secondary complications as say, a treatment for skin cancer might.
Says Dr. Joel Schlessinger, president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, “In my practice, if you call up, you’re put in the same pecking order as a medical patient. But in some practices, it is easier to get in as a cosmetic patient than a medical patient. They reserve certain slots and the medical slots just fill up quicker.” Although it shouldn’t be a surprise that some doctors don’t practice medical dermatology, there are some doctors opting to only offer cosmetic procedures. However, according to Schlessinger, it is estimated that about 75% of the 1,100 doctors in the American Society of Cosmetic Dermatology and Aesthetic Surgery continue to practice both types of medicine.
Alexa Kimball, assistant professor of dermatology at Harvard Medical School, believes that this shortage of dermatologists is due to a general shortage of physicians, which is only going to continue in the years to come. “We’re struggling mightily both in dermatology and in medicine overall as to how we’re going to handle a shortage of physicians in the future,” Kimball says. Blaming long wait times on cosmetic procedures is only a small part of the whole story. Even if cosmetic procedures no longer used up available appointments, there would likely still be a wait to see a dermatologist.