Assessing wait times for new dermatology patients: A secret shopper study across United States academic centers

Access to dermatologic care varies by visit type and urgency. Academic programs serve as important referral centers, yet appointment wait times remain understudied. Using a cross-sectional secret shopper study, we evaluated wait times for new patient dermatology appointments. Calls were made to accredited residency-affiliated clinics requesting appointments for three standardized scenarios: (1) urgent lesion (changing/bleeding mole), (2) routine total body skin exam, and (3) new-onset dermatitis. All inquiries assumed cash-pay status. Median wait times for the first, second, and third available appointments across 113 United States academic medical dermatology clinics were evaluated. Median wait times differed across visit types. Although urgent lesion appointments were scheduled most quickly (median: 71.5 days, IQR: 26.8-109.8), compared with dermatitis (median: 92.0 days, IQR: 66.0-138.0) and total body skin exams (median: 88.0 days, IQR: 64.0-134.0), wait times far exceeded those previously reported in community settings. Pairwise comparisons revealed urgent lesion visits were scheduled significantly sooner than either dermatitis or total body skin exam visits (p < .0001 for both contrasts), whereas no difference was observed between dermatitis and total body skin exam wait times. Substantial inter-program variability was noted, ranging from same-week to several-month delays. Academic dermatology clinics prioritize suspected malignancies but show little differentiation between dermatitis and routine visits. Even for suspected cancers, median wait times exceeded 70 days, raising concern for significant delays in diagnosis. These findings highlight the need for scheduling strategies that ensure timely access for urgent cancer concerns as well as inflammatory skin disease.