Long Wait Times in Dermatology Harm Patient Experience, Safety

Long wait times for dermatology appointments is impeding the patient experience, causing patients worry and putting patients at risk for worsening conditions, according to a new report from the Greater Access for Patients Partnership (GAPP).

Since 2009, patient wait times for a dermatology appointment have increased by 46 percent, or from an average of 22.1 days to 32.3 days in 2017. Four in 10 patients reported waiting between one and six months for their initial appointments, while patients waited an average of six weeks to have a follow-up appointment.

Long appointment times are impacting some patients more than others, the researchers added. For example, patients living in rural areas face longer wait times than those living in urban or suburban areas.

This is likely because there are fewer practicing dermatologists in rural regions, making it more difficult for patients to obtain an appointment. Compounding this issue are the geographic barriers many rural dwellers face.

Seventy percent of all patients said they wished their appointment wait times were shorter, the report noted.

Long appointment wait times are putting patient health at risk. Millions of Americans across the country experience some sort of skin issue, spanning from more cosmetic or uncomfortable issues such as acne all the way to life-threatening conditions such as skin cancer. Over 50 million patients have acne, the report noted, while 5.6 million have a skin cancer diagnosis.

Timely access to dermatological care could have a positive impact on those conditions. Providing specialty treatment to a possible melanoma within 14 days of diagnosis could improve a patient’s prognosis by 20 percent, the researchers reported.

Immediate treatment of more acute skin conditions, such as rashes or infections, could also prevent more catastrophic health events.

Between 2005 and 2011, there was a 17 percent increase in the number of hospitalizations for skin infections. When certain rashes or infections are left untreated, patients run the risk of developing a serious condition, such as MRSA.

Overall, 90 percent of all patients said their conditions worsened while they waited for a dermatology appointment.

In addition to risking patient health, long wait times are harming the patient experience and causing patients to worry. Fifty-four percent of patients said they experienced fear or anxiety while waiting for an appointment, with 58 percent of them saying they were concerned their conditions would worsen before they could see a doctor.

About half of all patients said they were upset about any activities they had to miss out on because their conditions limited them while waiting for their appointment.

Long wait times are also hurting patients’ pocketbooks. Forty-eight percent of respondents said they used over the counter medications to manage their conditions while waiting for their appointment. Fifty-three percent of those patients said the cost was a significant burden for them.

One key solution to the long wait time issue is having more providers qualified to treat dermatological issues, GAPP said. Specifically, hiring more nurse practitioners and physician assistants who specialize in dermatology could fill care gaps.

Eight in 10 patients said they would be interested in visiting with an NP or PA if they could experience a shorter wait time.

Data shows that NPs or PAs could shorten wait times. On average, wait times to see an NP or PA are 19 days, compared to the 56-day wait time associated with most physicians specializing in dermatology. This comes even as fewer than half of all dermatology offices employ an NP or PA.

Patients are also leaning on their primary care providers to answer questions about their skin issues. Between 6 and 7 percent of all PCP visits are associated with a skin condition query.

Providing continuing medical education in dermatology could help PCPs fill these gaps. Additionally, access to telehealth technology has shown successful at improving patient access to dermatology care.