title: A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.
abstract: BACKGROUND
  Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services.
  
  
  METHODS
  A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service.
  
  
  RESULTS
  Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05). Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4-3.4), followed by Urgent care (9.0 weeks; IQR = 2.1-12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks).
  
  
  CONCLUSIONS
  Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Canada.|Division of Dermatology, Women's College Hospital, Toronto, Canada.
authors.forename: Geeta
authors.initials: G
authors.lastname: Yadav
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Hanna R
authors.initials: HR
authors.lastname: Goldberg
authors.affiliation: Department of Psychology, University of Toronto, Toronto, Canada.
authors.forename: Morgan D
authors.initials: MD
authors.lastname: Barense
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Canada.|Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada.|Departments of Medicine and Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.|Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D003358:Cosmetics; D003430:Cross-Sectional Studies; D003880:Dermatology; D014850:Waiting Lists
chemical_list: D003358:Cosmetics