The care gap: Wait time inequities in comprehensive urgent and cosmetic dermatology care
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Abstract Body: This study evaluated disparities in comprehensive (consultation plus procedure) and procedure-only wait times between urgent melanoma care and elective cosmetic care, and the impact of workforce composition, including dermatologists and advanced practice providers (APPs). Data on workforce composition and wait times for mole evaluations, cosmetic consultations, melanoma excisions, and dermal fillers from 122 dermatology clinics in the southern United States were collected from October to December 2024. Comprehensive and procedure-only wait times were analyzed using paired comparisons, with multiple linear regression assessing the impact of workforce composition on access to care. Comprehensive melanoma wait times (mean: 45.88 ± 29.09 days) were significantly longer than comprehensive filler wait times (mean: 20.34 ± 23.09 days), with 92.9% of clinics reporting longer melanoma wait times (p<0.001). Procedure-only wait times for melanoma excisions (mean: 11.23 ± 6.43 days) were also significantly longer than filler procedure wait times (mean: 3.58 ± 13.29 days) in 93.1% of clinics (p<0.001). Sensitivity analyses confirmed these findings (p<0.001). Regression analyses revealed that APP availability significantly reduced comprehensive melanoma wait times both before (β= −7.69, p=0.009) and after sensitivity testing (β= −6.47, p=0.012). Procedure-only wait times were not significantly influenced by staffing. Significant disparities exist in wait times for urgent melanoma care compared to elective cosmetic care, and APPs most likely reduce comprehensive melanoma wait times by addressing bottlenecks in consultation phases. Policymakers should expand APP roles in dermatology and prioritize resource allocation to reduce disparities while optimizing access to comprehensive melanoma care. Charlotte McRae<sup>1</sup>, Ella Nichols<sup>1</sup>, Connor Sisk<sup>1</sup>, Michael Anderson<sup>1</sup>, Laci Turner<sup>1</sup>, Tiffany Mayo<sup>1</sup> 1. Dermatology, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States. Clinical Research: Epidemiology and Observational Research