Dermatology workforce in the United States – Part I: Overview, transformations, and implications

Commentary on “Publication Productivity Using H-Index to Evaluate Academic Success Among Fellowship-Trained Mohs Surgeons”

“…Of the 1150 ACMS members reviewed, 122 (10.6%) were employed in an academic setting. 10.6% is within estimates in dermatology as a whole, ranging from 6% to 15%, 5,6 and probably more realistic than the 29% estimate of ACMS members in an academic setting by Kohli and colleagues, 7 which was based on survey responses from 227 ACMS members. However, of 421 Micrographic Surgery and Dermatologic Oncology fellowship graduates from 2012 to 2017, 127 (30.2%) were employed by an academic setting for their first job.…”

Image Guided Superficial Radiation Therapy Expands Access to a Multidisciplinary Cancer Care Model that Optimizes Outcomes for Underserved Rural Medical Beneficiaries

“…These shortages are present because 95% of rural counties do not have a Mohs surgeon and only 13% of radiation oncologists practice in rural areas. [2,13] For rural Medicare beneficiaries who lack access to Mohs surgery and radiation oncology specialists, IGSRT solves the access problem. IGSRT accomplishes this goal by providing rural general dermatologists (who outnumber Mohs surgeons 10 to 1) with a multidisciplinary cancer care team to provide skin cancer treatment without delay.…”

“…The two main diseases primarily responsible for increasing rural mortality rates are heart disease and cancer [1]. The lack of access to dermatologists in rural areas has led to a higher risk of death from melanoma in rural Medicare beneficiaries [2]. New research demonstrates that more patients are dying from nonmelanoma skin cancer (NMSC) than melanoma worldwide [3,4].…”

“…Mohs micrographic surgery (MMS) is currently the gold standard treatment for NMSC due to its high cure rates ranging between 95-99% [6][7][8]. However, there is a significant maldistribution of surgeons, with only 11% of dermatologists performing Mohs surgery, and 95% of rural or non-metro counties lacking a Mohs surgeon [2]. Image Guided Superficial Radiation Therapy (IGSRT) has a 99% cure rates for the noninvasive treatment of NMSC [9][10][11][12], and a recent meta-analysis demonstrated that IGSRT has fewer recurrences than MMS [13].…”

Cooling Research Fever in Dermatology—The Role of Community Service

“…Overwhelmingly, the US dermatology workforce consists of physicians working in the community in private practices rather than research or academia. A 2020 study found that only 15% of dermatologists practice in academic settings, whereas 79% practice within community settings as either solo practitioners or members of a single-specialty or multispecialty group . This misalignment between the overemphasis placed on research and the realities of current-day practice is to the detriment of patients and trainees alike, as research fever may not necessarily equip future generations of dermatologists with the knowledge, experience, and skill sets needed to serve patients within the community.…”