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More than half of dermatology practices have separated in recent years, which has influenced how skin of color and other areas of dermatology study are taught across the United States.
In a recent cross-sectional study into the trends of dermatology practices, it was revealed that 51/3% of dermatologist practices and positions were separated from 2014-2020.
The data was collected from archived version of the Centers for Medicare & Medicaid Services Physician Compare Database and indicated that practice separation was more common in geographic regions in the Northeast and West.
This study, which was led by Thomas Cwalina, MBA of the Department of Dermatology at the University Hospitals Cleveland Medical Center, was one of the first to acknowledge trends in dermatologist density across the United States in recent years.
Previous reports of workforce density in the dermatology field from 2017 revealed an increase over the past decade, with an estimated 3.4 practices per 100,000 individuals. Despite this, the number of practices was still below the suggested 4 per 100,000 population needed to adequately care for patients with skin conditions.
Furthermore, the demand for dermatologic care has increased across the country for a myriad of reasons including higher incidence of complex inflammatory disorders, surgical and non-invasive dermatology procedures, and increased population density.
The implications of dermatologic workforce density on patients with skin of color, as well as dermatologists themselves, can vary dramatically depending on location.
In a wide-ranging interview with HCPLive, Karan Lal, MD, FAAD, Schweiger Dermatology Group, spoke of how dermatologists could experience greater or lesser exposure to skin of color depending on where their practice is in the country.
“Some (dermatologists), if you're working in, Danville, Pennsylvania, for example, you're going to get a very homogenous population of people,” Lal said. “Interestingly, I did a rotation at Cook County in Chicago, (and) all they saw was skin of color, it was like 98% of the clinic. So, residents from that training program are so much better at diagnosing skin color patients, then they would a White patient, for example, because their bias is seeing skin of color. It's so interesting that while you're training really dictates what you become interested in your expertise.”
Though dermatology practices are continuing to separate, diversity programs and task forces have been developed in recent years to continue educating dermatologists and residents on skin of color.
Similarly, programs such as Nancy Esterly Pediatric Dermatology Visiting Lectureship program have allowed experts in dermatology specialties such as pediatric dermatology travel across the country to conduct lectures, seminars, and rounds to promote inclusivity and diversity in skin studies.
“Thinking about the historically Black colleges and universities, there are a number of medical schools and whether we can partner with them to really increase sort of the just awareness of pediatric dermatology, and then being able to move on and inspire people, like we're already doing with this program, I think is something that's really, really important,” Bellet said in a recent interview about the program.