CHICAGO – Geographic maldistribution of trained pediatric dermatologists and long wait times for new-patient appointments are two key hurdles impacting patient access to pediatric dermatology care, according to a survey of workforce trends.
“There are large areas of the country that don’t have any pediatric dermatologists, which influences how we can train dermatologists, pediatricians, and medical students who want to do pediatric dermatology,” study author Brea Prindaville, MD, said in an interview at the World Congress for Pediatric Dermatology. “We’re trying to keep an eye on how that’s going, and how we can improve not only the geographic distribution, but also the numbers that we have in the workforce.”
In a project spearheaded by the Society for Pediatric Dermatology (SPD) workforce committee, Dr. Prindaville of Children’s Mercy-Kansas City (Mo.) and her associates emailed a nine-question survey to the 484 SPD members in the United States to determine practice location, number and types of patients seen, wait times, and association with advance practice providers between November and December of 2016. In all, 146 surveys were completed, for a response rate of 30%. Of these, 75% were from board-certified pediatric dermatologists. The majority of survey respondents were practicing in and around large cities, while 60% of all respondents and 68% of board-certified respondents were practicing full-time, seeing pediatric patients exclusively. An additional 30% were practicing part-time or also seeing adults. Board-certified pediatric dermatologists saw an average of 80 pediatric patients per week.Pediatr Dermatol. 2015;32:1-12). “Educating primary care providers about management of common skin conditions may help to alleviate restricted access to dermatologic care,” Dr. Prindaville and her associates wrote in their abstract. “Primary care management of common skin conditions, or follow-up for conditions with an established diagnosis and treatment plan, could free appointment times for patients that require pediatric dermatology subspecialty evaluation and treatment.”
Only 10% of survey respondents did not accept Medicaid, and about 50% of patients seen by board-certified pediatric dermatologists were insured by Medicaid. In addition, about half of respondents worked with one to three advanced practice providers.
Dr. Prindaville, who helped conduct the study during her pediatric dermatology fellowship at the University of Massachusetts, Worcester, acknowledged certain limitations of the analysis, including its low response rate, the limited number of survey questions, and the question design. Going forward, she and her associates hope to keep a pulse on workplace trends by surveying SPD members annually, perhaps with membership renewal.
The survey was supported by the SPD. Dr. Prindaville reported having no relevant financial disclosures.