Physician Extenders Reduce Wait Times for Dermatology Appointments, Study Finds

There may be an association between the availability of a physician extender and length of time a patient waits for dermatology appointments in Ohio, according to a study.

A study in JAMA Dermatology investigated the average appointment wait time to see a dermatologist in Ohio in order to determine the effects of the availability of a physician extender on scheduling. The authors called each of the 337 board-certified dermatologists in Ohio in the American Academy of Dermatology and the American Osteopathic College of Dermatology. For each call, the researchers acted as a new patient with concerns for cancer due to a changing skin mole. Through an algorithm of questions, the wait time for the next available appointment with a dermatologist was determined, as well as the availability of physician extenders in each specific office.

“The term physician extender is generally defined as a physician assistant, nurse practitioner, or physician not board-certified in dermatology," the authors of the research letter explained. "The Society of Dermatology Physician Assistants has grown from 49 members in 1994 to more than 2700 members in 2014. However, the association between the use of physician extender and current wait times to see a dermatologist is not well established."

Of the 269 practicing, medical dermatologists in Ohio who were included in the study, 236 (87.7%) were a doctor of medicine, 33 (12.3%) were a doctor of osteopathy, while 183 (68%) of the offices were staffed by dermatologists only. The average wait time to see a dermatologist was 56 days with a median of 41 days.

Additionally, the average wait time to see a physician extender was 19 days and they were available in 86 offices (32%). The offices without available physician extender appointments had a mean wait time of 60 days to see a dermatologist while offices with a physician extender had a mean wait time of 48 days to see a dermatologist.

When compared with the results of a 2009 study, the researchers concluded that the wait times to see a dermatologist have almost doubled in Ohio. This extensive wait time could discourage patients from making appointments or to see a less experienced physician for diagnosis, according to the study.

“As a multitiered community of trained and certified medical professionals in the field of dermatology, we need to determine an acceptable wait time range for patients with a concern for skin cancer, to evaluate and determine whether we are meeting that measure, and to promptly make adjustments in the dermatology physician workforce (which may include physician extenders who work in dermatology offices), if needed,” the authors concluded.