How Smart Clinic Redesign is Solving the Dermatology Access Crisis
Imagine being told you have a suspicious spot on your skin, only to learn the earliest available appointment with a specialist is more than a year away.
Access to dermatology care has emerged as a critical challenge in healthcare systems worldwide, creating a domino effect that delays diagnosis and increases patient anxiety.
Research has identified the most significant obstacles as continuous lack of insurance, residence in medically underserved counties, and income below the federal poverty level 7 .
For skin cancers, early detection directly correlates with better outcomes and reduced mortality 7 . When patients face extended waits measured in months or years rather than weeks, potentially treatable conditions can progress to critical stages.
Dermatologists per 100,000 people
Projected increase in demand (2013-2025)
Populations most affected
The challenge in dermatology access reflects broader specialty care shortages. Studies indicate approximately 3.4 dermatologists exist per 100,000 people, insufficient to meet community needs 7 . This shortage is expected to intensify, with projections suggesting a 16% increase in demand for dermatology visits between 2013 and 2025 7 .
Percentage facing significant barriers to dermatology care
The situation creates particular hardship for vulnerable populations. Safety net health systems, which provide care regardless of patients' ability to pay, bear the brunt of this imbalance 3 . As one study noted, "The poor, those who live in rural areas, and high minority locations lack access to dermatologists" 7 .
"When Dr. Benjamin Chong began working at the dermatology clinic of Parkland Memorial Hospital, a safety net hospital in Dallas, the wait times for new patients exceeded one year."
Patients with stable, low-acuity conditions like mild acne were discharged back to their primary care physicians with clear management plans 3 .
The clinic established consistent targets for both new and established patient appointments across all clinic sessions 3 .
The team hired an additional licensed vocational nurse and adjusted support staff schedules to ensure consistent coverage 3 .
A specific resident-physician and nurse were assigned to perform all biopsies for the clinic 3 .
A physician assistant was hired to manage low-acuity dermatology cases 3 .
| Metric | FY 2011-2012 | FY 2014-2015 | Change |
|---|---|---|---|
| Total Clinic Visits | 8,030 | 9,730 | +21% |
| New Patient Completed Visits | 2,438 | 3,400 | +39% |
| Patients Discharged from Clinic | 1,832 | 1,991 | +9% |
"Overall, we were surprised but pleased to find that relatively minor modifications could reduce wait times so drastically."
The success at Parkland didn't require groundbreaking technology but rather the strategic application of operational improvements.
Systematically categorizing referrals by urgency to prioritize potentially serious conditions.
Physician assistants and nurse practitioners managing stable, low-acuity conditions under supervision.
Establishing consistent scheduling patterns with defined slots for new and follow-up patients.
Specific staff assigned solely to biopsies and other time-consuming procedures.
Using store-and-forward or live video consultations for appropriate cases.
The implications of successful dermatology pathway redesign extend far beyond skin cancer. The same principles could revolutionize access to other specialty services facing similar challenges.
Expanded initiatives
Expanded initiatives
Potential for application
"It's critical that we can provide patients with the care they need when they need it. The dermatology clinic's efforts have been tremendous — wait times have been reduced from a year to just weeks."
The broader lesson from this case study is that solving healthcare access problems often requires looking beyond simply adding more providers. Instead, the most effective solutions may come from rethinking how we use existing resources through operational innovation, strategic prioritization, and breaking down traditional silos between primary and specialty care.
References will be populated here.