Assessing Wait Times for New Dermatology Patients: A Secret Shopper Study Across US Academic Centers

Area of Science:

• Dermatology
• Health Services Research
• Medical Education

Background:

• Access to dermatologic care is crucial but varies significantly.
• Academic medical centers are key referral sites, yet patient appointment wait times are not well understood.
• Understanding wait times is essential for improving patient access to dermatologic services.

Purpose of the Study:

• To evaluate new patient appointment wait times at U.S. academic medical dermatology clinics.
• To compare wait times across different visit types: urgent lesion, routine total body skin exam (TBSE), and new-onset rash.
• To identify potential disparities in access to care within academic dermatology settings.

Main Methods:

• A cross-sectional, secret shopper study design was employed.
• Standardized appointment requests were made for three scenarios (urgent lesion, TBSE, rash) to 113 accredited residency-affiliated clinics.
• Data on median wait times for the first available appointments were collected and analyzed, assuming cash-pay status.

Main Results:

• Median wait times varied by visit type, with urgent lesions (71.5 days) being shortest, followed by TBSEs (88 days) and rashes (92 days).
• Wait times for all visit types significantly exceeded those reported in community settings.
• Urgent lesion appointments were scheduled significantly faster than rash or TBSE appointments (p < 0.0001), but no difference was found between rash and TBSE wait times.

Conclusions:

• Academic dermatology clinics prioritize urgent cancer concerns but show minimal differentiation between rashes and routine exams in scheduling.
• Median wait times exceeding 70 days for urgent lesions raise concerns about diagnostic delays.
• Improved scheduling strategies are needed to ensure timely access for both urgent oncologic and inflammatory skin conditions.