Feature

50 years of growth: More dermatologists, more demand


 

A dive into the dermatology data pool reveals a great deal of change in the 50 years that Dermatology News and Skin & Allergy News have been covering the specialty.

For one thing, there are a lot more dermatologists now. In 1970, there were 4,004 dermatologists in the United States, according to the American Medical Association, and as of 2019, the total was up to 19,957. The American Academy of Dermatology puts its 2020 membership at a somewhat lower 18,898, noting that not all dermatologists are AAD members.

Much of that 50-year increase comes from the larger proportion of women entering the specialty. In 1970, only 7% of dermatologists were women, but by 2019 they represented over 37% of the dermatology workforce, according to the AMA numbers. The AAD, however, reports more women than the AMA (8,940 vs. 7,482), so the proportion of female academy members in 2020 is about 47%.

The population of dermatologists has increased faster than the general population since 1970, leading to a rising density of providers. A report from 1973 put the national figure at 1.7 dermatologists per 100,000 population in 1970, and two more recent studies in JAMA Dermatology reported density levels of 3.65 per 100,000 in 2013 and 3.36 per 100,000 in 2016.

In that 1973 report, the authors said that there was “no evidence to suggest that there will not be sufficient dermatologists in the future, if training centers are maintained and adequately financed,” noting that “the current rate of filling of dermatologic residency positions should not diminish and may continue to increase.”

In 2017, the conclusion was quite different: “Dermatologists alone have been unable to meet increasing patient demand for dermatologic services. The number of dermatology residency training positions has been relatively stagnant, suggesting that the current supply of dermatologists in training will be insufficient to fully meet growing future demand.”

The current state of strong demand for dermatologists does come with some benefits. In a 2019 survey by physician recruitment firm Merritt Hawkins, dermatologists had the 6th-highest starting salary at $420,000 a year. An article in the July 1971 issue of Skin & Allergy News offered a somewhat different perspective on compensation for first-year dermatologists: Recommendations offered by those already in practice ranged from $12,000 to $24,000.

Those first-year physicians are coming from residencies that, not too surprisingly, are now producing more new dermatologists than they did in 1970, although perhaps not as many more as might be expected.

There were an estimated 250 individuals completing dermatology residencies annually in 1976 (J Am Acad Dermatol. 1981;4[3]:344-5), which suggests a total of approximately 750 active residents at a time when there were about 5,000 practicing dermatologists in the country.

For the 2018-2019 academic year, there were 1,439 active residents in U.S. training programs, according to the Association of American Medical Colleges, so there were twice the number of residents but four times as many dermatologists in practice, compared with 1976.

The next link in the dermatology supply chain would be the medical schools, and there the numbers of full-time faculty have more than kept up. For the 1969-1970 academic year, there were 202 full-time positions in dermatology (JAMA. 1970;214:1483-581). By 2019, the number had risen to 1,519, according to the Association of American Medical Colleges.

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