The US dermatology workforce: A specialty remains in shortage

Kimball, Alexa B.; Resneck, Jack S.

doi:10.1016/j.jaad.2008.06.037

Cited by 228 publications

(203 citation statements)

References 23 publications

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“…In 2007, the mean wait time for new patients in urban areas to see a dermatologist was 33 days; in rural areas, the number rises to 46 days. 25 Furthermore, delay in diagnosis due to "off site" analysis imparts an emotional cost to the patient.…”

Section: A Skin Cancermentioning

confidence: 99%

Design and characterization of a novel multimodal fiber-optic probe and spectroscopy system for skin cancer applications

Sharma

Marple²,

Reichenberg

et al. 2014

Review of Scientific Instruments

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The design and characterization of an instrument combining Raman, fluorescence, and reflectance spectroscopic modalities is presented. Instrument development has targeted skin cancer applications as a novel fiber-optic probe has been specially designed to interrogate cutaneous lesions. The instrument is modular and both its software and hardware components are described in depth. Characterization of the fiber-optic probe is also presented, which details the probe's ability to measure diagnostically important parameters such as intrinsic fluorescence and absorption and reduced scattering coefficients along with critical performance metrics such as high Raman signal-to-noise ratios at clinically practical exposure times. Validation results using liquid phantoms show that the probe and system can extract absorption and scattering coefficients with less than 10% error. As the goal is to use the instrument for the clinical early detection of skin cancer, preliminary clinical data are also presented, which indicates our system's ability to measure physiological quantities such as relative collagen and nicotinamide adenine dinucleotide concentration, oxygen saturation, blood volume fraction, and mean vessel diameter.

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Section: A Skin Cancermentioning

confidence: 99%

Design and characterization of a novel multimodal fiber-optic probe and spectroscopy system for skin cancer applications

Sharma

Marple²,

Reichenberg

et al. 2014

Review of Scientific Instruments

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show abstract

“…21,22 Dermatologists have been among those physicians receiving termination letters from MA plans without warning or explanation. [23][24][25] There are concerns that state and federal regulators responsible for ensuring network adequacy and patient access to care might rely on the same lists of in-network physicians that insurers are using to populate their public online directories.…”

mentioning

confidence: 99%

The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks

et al. 2014

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IMPORTANCE Insurers are increasingly deploying “narrow networks” with fewer contracted physicians both in health plans offered in new state exchanges under the Affordable Care Act and in Medicare Advantage (MA) plans, which are commercial alternatives offered to Medicare beneficiaries. Patients choosing health plans rely on the accuracy of network directories posted by insurers. The MA plans must meet network adequacy requirements,and inaccurate directories of participating physicians might prejudice those determinations.OBJECTIVE To determine the accuracy of MA plan directories of participating dermatologists,and the appointment availability of listed physicians.DESIGN, SETTING, AND PARTICIPANTS Scripted telephone calls were placed to every dermatologist listed in directories for the largest MA plans in 12 US metropolitan areas. The caller sought an appointment on behalf of his fictitious father who had severe itch for several months, asked whether the dermatologist accepted the relevant plan, and asked for the next available appointment date.MAIN OUTCOMES AND MEASURES Appointment availability and wait time.RESULTS Among 4754 total physician listings, 45.5%represented duplicates in the same plan directory. Among the remaining unique listings, 48.9% of physicians were reachable,accepted the listed plan, and offered an appointment for our fictitious patient. Many of the dermatologists listed had incorrect contact information, were deceased, retired, or had moved, were not accepting new patients, did not accept the insurance plan, or were subspecialized. The mean (range) wait time for appointments among the remaining listings was 45.5 (1-414) days. Both the accuracy of network directories and the appointment wait times varied substantially by health plan and metropolitan area. For 1 plan, our caller was unable to obtain an appointment with any listed dermatologist. CONCLUSIONS AND RELEVANCE Medicare Advantage physician directories for dermatology in many areas substantially overestimate the number of in-network physicians available to treat patients with medical skin conditions. These inaccuracies occurred in areas with long appointment wait times and where plans are terminating selected physician contracts. This suggests a lack of capacity that would be exacerbated by further network narrowing.Accurate physician directories are essential for proper oversight of network adequacy, and for patients who rely on these listings to evaluate health plan options during open enrollment.

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“…The 2002 study noted that nearly half of practicing dermatologists believe their community could use more dermatologists and one third are recruiting new associates and new graduates are readily able to find jobs. 50 …”

Section: Dermatology (2008) -"Stable Undersupply Of Dermatologic Servmentioning

confidence: 99%

Non-Physician Clinicians in GI Practice Part 1: Current Status and Utilization

Moses

McKibbin

2017

American Journal of Gastroenterology

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The US dermatology workforce: A specialty remains in shortage

Cited by 228 publications

References 23 publications

Design and characterization of a novel multimodal fiber-optic probe and spectroscopy system for skin cancer applications

Design and characterization of a novel multimodal fiber-optic probe and spectroscopy system for skin cancer applications

The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks

Non-Physician Clinicians in GI Practice Part 1: Current Status and Utilization

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