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Apointment delays longer for suspicious moles than for Botox tx


Patients waiting to have a mole examined will find themselves in a longer queue than patients waiting for cosmetic botulinum toxin (Botox, Allergan) injections, according to research results published in the Journal of the American Academy of Dermatology.

Key Points

Researchers compared the responses of scripted patient telephone calls made to 898 dermatologists in 12 metropolitan areas throughout the United States, to assess waiting times for Botox injections. Thirty-seven percent were female.

Half of dermatologist respondents (455; 50.7 percent) offered appointments for injections of Botox, and the median wait time was eight days.

Dermatologists contacted in the recent survey were all members of the American Academy of Dermatology (AAD). Respondents who were considered not to be actively caring for an adult population were excluded.

Wait times vary

Acceptance rates and wait times varied tremendously by geographic area, with median wait times ranging from 6.0 to 32.5 days. Dermatologists in Miami, Fla., (68 percent) and Orange County, Calif., (65 percent) were most likely to provide the cosmetic treatment with a short wait time.

Other sites were Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Newark, N.J.; Phoenix; Seattle; and Syracuse, N.Y.

"The study was not designed to answer the 'why' of the difference in wait times," explains Jack Resneck Jr., M.D., the study's lead investigator and assistant professor of dermatology and health policy at the University of California, San Francisco, School of Medicine.

"It may leave an impression that most dermatologists are spending their time on cosmetic procedures, but that is not the case," Dr. Resneck stresses. "We know that there is a shortage of dermatologists in the country. As a field, we want to make sure patients who have the most severe or worrisome problems are seen as quickly as they need to be seen."

Dr. Resneck attributes the longer wait times for evaluation of a changing mole to scarce dollars available to train new dermatologists.

More than a quarter of the dermatologists who responded to the phone query were working with physician extenders - either a physician assistant or a nurse practitioner - in their offices. Dermatologists who were female and those who offered Botox injections were more likely to use physician extenders.

There are an estimated 10,000 active dermatologists in the United States, according to the Association of American Medical Colleges. A study published in 2004 found that one-third of U.S. dermatologists were seeking additional dermatologists for their practices. About 300 to 350 graduates are produced annually, according to the Journal of the American Medical Association.

AAD weighs remedies

While the overall shortage and uneven distribution of practitioners in dermatology in the United States is not unique to the specialty, the AAD has been monitoring the human resources situation.

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