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Are Physician Extenders the Answer to the Dermatologist Shortage?

As the aging population continues to grow, so does the need for more physicians. A 2015 report from the Association of American Medical Colleges found that the demand for doctors will increase 17 percent from 2013 to 2025. This means that the already dire dermatologist shortage will only continue to worsen. In an effort to figure out ways to decrease dermatologist appointment wait times, researchers at the Northeast Ohio Medical University found that by scheduling an appointment with a physician extender, patients were able to receive diagnosis and treatment much faster.

In a study published in JAMA Dermatology in September, the researchers assessed 269 dermatology practices in Ohio by calling each one individually and pretending to make an appointment as a patient. They found that only 86 (32 percent) had a physician extender, and 183 (68 percent) only had a dermatologist on staff. Physician extenders are most commonly physician assistants, nurse practitioners, or physicians who are not board certified in dermatology. Dermatology practices without a physician extender had a mean appointment wait time of 56 days, and offices with a physician extender had a much shorter wait time of 19 days. During the calling process, the researchers found that offices that couldn’t schedule an appointment with a physician extender had a mean wait time of 60 days. Practices that did have a physician extender offered an appointment wait time of 48 days.

“I think the story here is that dermatologists are trying to address wait times by hiring and working with physician assistants and nurse practitioners,” said one of the study’s authors Eliot N. Mostow, MD, MPH. “Perhaps it’s not working perfectly, but it seems to have significant benefits for patients and practices that have embraced the collaboration, hopefully working to make sure the quality of care always stays high with good communication and oversight.”

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