Dermatology: Supply and Demand

Dermatologists specialize in a branch of medicine that focuses on the diagnosis and treatment of diseases of the skin, hair and nails. Medical dermatologists treat a variety of common skin conditions including acne, dermatitis, warts, psoriasis, rosacea, eczema, skin cancer screening, skin growths/infections, nail disorders and hair loss. Fellow-trained Mohs surgeons and dermatological surgeons have expertise in skin cancer assessment and treatment, destruction and removal of benign, malignant and malignant skin lesions, nail surgery and evaluation and treatment of skin cancer using Mohs micrographic surgery and facial reconstruction.

Current demand for dermatologists far exceeds supply. Dermatologists see men and women in relatively equal numbers and see all age groups, but most dermatology visits are from patients between the ages of 10-55 and 65+. Given the skin cancer epidemic (over a million cases a year) and an aging population, dermatologists are in very high demand with an average wait of 6-8 weeks to see one. Nationally, the ratio of dermatologists to patients is about 1:33,000, but this is much higher in rural areas. These rates have been similar for several decades.

Because it is so difficult to develop new dermatology education programs, and given that many dermatology specializations have increased in recent years, it is nearly impossible to increase the number of dermatologists in a reasonable time frame. Recently some dermatologists specialize in cosmetology, so they do not treat skin cancers or offer medical dermatology. Also, about 65% of dermatologists are over the age of 54 and will retire soon, further adding to the shortage. Because dermatology is currently one of the top three most competitive specialties in medicine, few foreign medical students are able to enter residency training programs such as internal medicine or family medicine programs. The relatively high percentage of women entering the dermatology workforce in fewer than full-time positions also limits how many patients can be seen. All these factors will continue to provide the necessity of good dermatologists for many years.

Healthcare reform is a mild concern for dermatologists as it could mean cutbacks in Medicare reimbursement, but given that it could be changed with each new Presidency and the utterly unsuccessful failure of the HMO experiment, patients are likely to tolerate lower insurance coverage/care and higher insurance coverage. premiums are low.

Mohs surgeons are also in high demand, especially in rural areas. Like many specialists, Mohs surgeons are concentrated in major urban centers, but there are a few Mohs Surgeons who serve rural areas and have very intensive practices. The skin cancer epidemic will continue to be the gold standard for the treatment of non-melanoma skin cancer in the head and neck and other body areas requiring tissue preservation, given the higher cure rates and cost-effectiveness of Mohs Micrographic surgery.

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