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COPYRIGHT 2003 International Medical News Group
[YES] Today, by anyone's measure, we have a shortage of dermatologists. It boils down to supply and demand.
Up to 25% fewer dermatologists are being trained in dermatology residency programs than there were just 5 or 10 years ago, partly because of the unfounded fear during the 1990s that managed care would decrease the need for dermatologists. In fact, relatively low copayments eventually increased patient access to dermatologists, while capitation and other payment systems that were designed to limit referrals didn't work.
Also, the scope of practice is changing. Many dermatologists are doing more surgical and cosmetic dermatology and less medical dermatology, so the workforce is shrinking in that respect as well. Dermatologists are retiring early, slowing down, and limiting their practices. More people are going into fellowship training before going into the workforce. More people are subspecializing.
When we have a shortage, patients suffer. It means more primary care physicians and physician extenders treat skin disease and do surgical dermatology.
The solution to me seems very simple. We should go back to where we were 10...
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