Workforce requirements for keratinous cysts: clinicians expend 1200 full-time effort years annually

Keratinous cysts are amongst the 10 most common dermatologic ambulatory diagnoses. Thus, we aimed to estimate the time and cost spent annually on management of keratinous cysts. We conducted a cross-sectional study using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey between 2007 and 2018 (most recent years available). Conservatively, $2.1 billion per year was spent on healthcare for keratinous cysts. On average, the full-time work of 1200 (840-1800) physicians and non-physician providers are required to manage keratinous cysts yearly in the outpatient and emergency departments.We used Medicare reimbursement rates for the cost analysis which provides a conservative estimate of the total cost. Keratinous cysts impose a significant time and cost burden on the healthcare system. Treating inflamed, draining, or painful keratinous cysts or ones that occur in undesirable locations such as the face are likely of high-value due to the quality of life impact. Managing asymptomatic keratinous cysts may be of lower value. Given this burden, clinicians should continue to evaluate the value they are providing to the patient when managing keratinous cysts.