From the Guidelines
Disparities in access to dermatology care can be effectively addressed by implementing a multilevel approach that involves patients, health providers, local agencies, professional societies, and national governmental agencies, with a focus on telemedicine, community partnerships, and cross-cultural provider training. Disparities in access to dermatology care are significant and multifaceted, affecting racial and ethnic minorities, individuals with lower socioeconomic status, those living in rural areas, and the uninsured or underinsured 1. These disparities manifest as longer wait times for appointments, greater distances to travel to specialists, and fewer dermatologists accepting Medicaid. The consequences include delayed diagnoses of skin cancers, inadequate management of chronic conditions like psoriasis and eczema, and poorer outcomes overall. Contributing factors include the geographic maldistribution of dermatologists, insurance limitations, cultural and language barriers, and implicit bias among healthcare providers 1.
Some key factors to consider when addressing these disparities include:
- The use of telehealth to increase access to care for underserved populations 1
- The importance of cultural competency training for healthcare providers to reduce implicit bias and improve patient outcomes 1
- The need for policies to incentivize practice in underserved areas and increase the diversity of the dermatology workforce 1
- The role of community partnerships and collaborations in improving access to care and reducing health disparities 1
Implementing these strategies can help to reduce disparities in access to dermatology care and improve health outcomes for underserved populations. By prioritizing a multilevel approach that addresses the social determinants of health and promotes equity in access to care, we can work towards ensuring that all individuals have access to high-quality dermatology care, regardless of their background or socioeconomic status 1.
From the Research
Disparities in Access to Dermatology
- Disparities in access to dermatology care exist, with certain populations facing barriers to receiving timely and effective treatment 2, 3, 4, 5, 6
- Teledermatology has been shown to increase access to dermatology care, particularly among Medicaid-insured, resource-poor urban and rural, and elderly populations 2
- However, inconsistent access to technology may potentially increase disparities for some populations 2
Barriers to Access
- Lack of dermatologic training, time constraints, and competing comorbidities are common barriers reported by primary care physicians 4
- Low perceived risk, long delays in appointment, and lack of knowledge about melanoma are common barriers reported by patients 4
- Health system barriers include lack of public awareness, social prejudice, and intensive resource requirements for public surveillance programs 4
Racial and Ethnic Disparities
- Racial and ethnic disparities exist in access to emerging and frontline therapies for common dermatological conditions, such as acne, atopic dermatitis, and psoriasis 6
- Black patients are less likely to receive certain treatments, such as isotretinoin and dupilumab, compared to white patients 6
- Hispanic patients may also experience disparities in access to certain treatments, such as tretinoin 6