Botox trumps suspicious moles in dermatology queue

Mystifiedby asuspicious mole? Expect a long wait for a dermatologist.

Booking an appointment for esthetic purposes, however,islikely to get you in much more quickly in the U.S., according to a recent study.

The study, published in the Aug. 27 edition of the Journal of the American Academy of Dermatology, foundpatients seeking to havemoles assessed stood to wait much longer to see a skin specialist, compared toindividualswanting Botox injections to smooth out wrinkles.

According to the head of the Canadian Dermatology Association, wait times to see a specialist for medical reasons are even longer here in Canada.

The University of California researchers in the study released this week set out to determine whyregular and urgent dermatology appointments in the U.S. are typically three to four weeks.

Participants acting as patients made scripted telephone calls to 898 dermatologists in 12 U.S. metropolitan areas,asking for Botox appointments.

They compared the results to the findings of a previous study, with identical methodology,that examined wait timesto getevaluated forchanging moles, possible indicators of skin cancer.

Half of the dermatologists who responded offered Botox appointments, withthe median wait time of eight days. That compares tothe 26-day average wait time to see a dermatologist about a changing or suspicious mole.

Canadian wait times longer

In Canada, the average wait time to see a dermatologist is 42 days, said Dr. Jack Toole, president of the Canadian Dermatology Association in Winnipeg.

Tooletold CBCNews.ca on Wednesday thatthe high demand for dermatologists, coupled with a dearth of new doctorsandan increase inthe number of practitioners retiring, are reasons behind the lengthy wait times.

"In Canada, there's no question the demand for dermatology services outstrips the supply.

"We're concerned that we're not training enough dermatologists in Canada. If more training physicians aren't created, that [wait] time could grow," he predicted.

Toole said a 2006 survey conducted by the CDA's workforce committeesuggested 86 per cent of dermatologists devoted themselves exclusively to medical dermatology, while 14 per cent performed cosmetic procedures.

However, as public demand for the services grows, dermatologists are increasingly turning to "uninsured procedures" such as Botox injections, he said. Cosmetic procedures are paid for by the patient and can cost hundreds of dollars, while provincial health plans cover lower-cost regular visits.

According to Medicard Finance Inc. and Cosmetic Surgery Statistics Canada, 642,828 cosmetic procedures were conducted between April 2005 and 2006. Botox remains the top procedure, with more than 142,374 Canadians injected in 2005, according to the survey.

"The early diagnosis of skin cancer, particularly life-threatening melanoma, is actually critical to survival. So earlier is better." —Dr. Jack Toole

Toolesaid he suspectsthe number of dermatologists performing cosmetic procedures is increasing.

"As skin experts, we are in demand to deliver the cosmetic services. And there's no question there's a huge demand for it."

Urgent requests honoured

For patients with a suspicious moles, getting to a doctor can be a challenging process emotionally, said Toole.

"If you or I had a suspicious mole, we were worried about, we'd like to find out tomorrow. I think it would be much preferable to have less of a wait time."

While Toole wouldn't say a 42-day waiting period is dangerous if a mole turns out to be malignant melanoma, he said it's "undesirable."

"The early diagnosis of skin cancer, particularly life-threatening melanoma, is actually critical to survival. So earlier is better."

He said thatin cases where a family doctor has cancer suspicions, he canmark the referral to a dermatologist as urgent and get a specialist to see the patient within 24 hours.

But, he warned, "not everyone can get classified as urgent."