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Cited by 257Global Health Workforce IssuesDiversity and Career in MedicineHealthcare Systems and Challenges

The US dermatology workforce: a specialty remains in shortage.

Kimball, Alexa Boer, Resneck, Jack S.·2008·Journal of the American Academy of Dermatology
DOI 10.1016/j.jaad.2008.06.037
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Abstract

Introduction Since 1999, multiple surveys have documented a stable undersupply of dermatologic services in the United States. Factors contributing to the imbalance include changes in the demographics of the physician workforce, increased demand for services, and a limited number of training positions for new physicians. In response to the demand, there has also been a substantial influx of nonphysician clinicians into dermatology offices.Methods We sought to follow up the large data set collected by the American Academy of Dermatology in 2002; the survey was repeated in 2005 and 2007. Response rates ranged from 30% to 35% and included more than 1200 respondents each year.Results Few changes were noted in the metrics used to assess the balance of supply and demand in the US dermatology workforce between 2002 and 2007. Mean wait times for new patient appointments decreased slightly from 36 to 33 days. One third of practices continue to seek additional dermatologists. In 2007, 23% of practices reported employing a physician assistant and 10% a nurse practitioner (up from 15% and 8% in 2002). In 2007, typical dermatologists continued to spend the bulk of their direct patient care time in medical dermatology (23.9 hours, 63%), followed by surgery (10.2 hours, 27%), and then cosmetic dermatology (3.8 hours, 10%). A substantial subset of dermatologists (29%) spent half or more of their time in surgical and cosmetic dermatology combined. Although female dermatologists worked fewer total hours, they spent equal time caring for patients with medical dermatologic conditions, less time in surgical dermatology, and more time in cosmetic dermatology.Limitations The survey is potentially subject to inaccurate self-report and response bias. Although the results shed light on patient access and the dermatology workforce, they do not establish or quantify any impact on patients' health.Conclusions Between 2002 and 2007, despite continued increases in the number of nonphysician clinicians in US dermatology offices, there were only small changes in the overall metrics commonly used to assess workforce balance. These findings suggest persistent unmet demand, but, given divergent trends of ongoing increases in surgical and cosmetic dermatology, growth in the use of physician assistants and nurse practitioners, and an aging and expanding US population, the future balance of supply and demand remains difficult to predict. Nevertheless, careful workforce planning and deliberative consideration of the risks and benefits of rapidly emerging changes in the delivery of dermatologic care are essential to ensure access to high-quality care for patients with skin disease.

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  • The teledermatologists in California spent a similar amount of time in face-to-face medical dermatology as the general U.S. dermatology workforce, but significantly less time in surgical and cosmetic dermatology and more time in research and administration.

    “While the teledermatologists in California spent a similar amount of time in face-to-face medical dermatology, they spent significantly less time in surgical and cosmetic dermatology and more time in research and administration (Figure 1).”

    From Practice Models and Challenges in Teledermatology: A Study of Collective Experiences from Teledermatologists (2011) · cites this paper as [23]

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Authors
Kimball, A. B., & Resneck, J. S.
Affiliations
  • Harvard University (US)
  • University of California, San Francisco (US)
ORCID
Kimball, Alexa Boer
Venue
Journal of the American Academy of Dermatology
Publisher
Elsevier BV
Published
2008-11
Volume
59
Issue
5
Pages
741-745
ISSN
0190-9622 (ISSN-L)
DOI
10.1016/j.jaad.2008.06.037
OpenAlex
W2029114523
Cited by
257
References
27
Citations by year
2026: 9 · 2025: 10 · 2024: 12 · 2023: 12 · 2022: 9 · 2021: 23 · 2020: 21 · 2019: 21 · 2018: 25 · 2017: 17 · 2016: 13 · 2015: 19 · 2014: 14 · 2013: 11 · 2012: 9
FWCI
16.75
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of the American Academy of Dermatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Keywords
dermatology workforce, physician shortage, supply and demand balance, waiting time, non-physician clinicians, physician assistants, nurse practitioners, dermatologic surgery, cosmetic dermatology, clinical dermatology, physician time allocation, workforce planning, patient access, training positions, population aging
MeSH terms
Workforce, Adult, Cosmetic Techniques, Data Collection, Dermatology, Humans, Middle Aged, Physicians, Women, United States, Waiting Lists

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