title: Even patients with changing moles face long dermatology appointment wait-times: a study of simulated patient calls to dermatologists.
abstract: BACKGROUND
  Previous studies have shown long wait-times for general dermatology patients seeking routine appointments. No evidence has been gathered on wait-times for patients with urgent problems or on the impact of physician extenders on access to dermatologic care.
  
  
  OBJECTIVE
  To evaluate access for patients with an urgent problem, we performed scripted patient telephone calls to 851 dermatologists to assess wait-times for both patients with Medicare and those paying out-of-pocket complaining of a changing mole.
  
  
  RESULTS
  Mean wait-times were similarly long for patients paying out-of-pocket (38.2 days) and those on Medicare (38.9 days; P = .85). Acceptance rates and wait-times varied greatly by geographic area (range of mean wait-times, 19.7-73.4 days). Many dermatologists (23.3%) employed a physician extender, and the wait-times for these extenders (27.9 days) were significantly shorter than those for the physicians supervising them (45.8 days; P < .001).
  
  
  CONCLUSIONS
  The metropolitan areas sampled represented about one tenth of practicing dermatologists in the United States, and no remote or highly rural communities were included.
  
  
  CONCLUSIONS
  Patients with a changing pigmented lesion, a possible indicator of malignancy, face wait-times just as long as those previously published for patients with routine complaints. Medicare patients did not experience any greater barriers to access. Although the use of physician extenders remains controversial, these practitioners were able to schedule patients more quickly than their supervising physicians.
authors.affiliation: University of California, San Francisco School of Medicine, 94143-0316, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Tsang
authors.forename: Jack S
authors.initials: JS
authors.lastname: Resneck
mesh_terms: D001071:Appointments and Schedules; D003880:Dermatology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology; D016544:Patient Simulation; D012871:Skin Diseases / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology; D013997:Time Factors; D014850:Waiting Lists