Dermatologist wait times in Atlantic Canada

September 2013
Dermatologist wait times in Atlantic Canada
Ian Landells, MD, FRCPC
St John’s Dermatologist
Canadian Dermatology Association
In my private practice in St. John’s, a city with eight dermatologists, the standard wait time to see a
new patient for a non-urgent issue is six to eight months. Urgent cases such as melanoma are seen
very quickly, sometimes even within 24 hours.
Newfoundland and Labrador has one of the best dermatologist-to-patient ratios in Canada, thanks
to the hard work by current dermatologists that has gone into recruiting and retaining new ones. In
addition to the dermatologists in the capital city, there are two in Grand Falls in central
Newfoundland and, for about 10 days each month, a dermatologist from British Columbia consults
in Corner Brook in the western part of the province.
But it’s not all good news. Last year, the Canadian Skin Patient Alliance released Skin Deep: A
Report Card on Access to Dermatological Care and Treatment in Canada. It was part of the CSPA’s
advocacy efforts to objectively investigate and evaluate how the publicly funded health care
systems are performing.
The report card revealed that Canada gets a failing grade overall for dermatologist wait times and
accessibility.
Atlantic Canada shares some of the same challenges as the rest of the country. A survey conducted
independently on behalf of the CSPA in February–March 2011 showed that half of Atlantic
Canadians wait at least 23 weeks for an initial consultation—the longest wait time in Canada. Onequarter of patients must wait at least eight months for an appointment.
In spite of its attraction and retention success, according to the CSPA, Newfoundland and Labrador
has failed to provide the level of dermatology care required to meet the needs of its patients. The
report card revealed that those patients can wait anywhere from two to 52 weeks for an
appointment.
In New Brunswick, patients also typically experience long wait times for routine appointments,
ranging anywhere from four months to a full year. Nova Scotians can wait up to five times longer
for treatment than generally accepted waiting periods; like New Brunswick, from four months to a
year. Nova Scotia also received poor grades for the number of dermatologists in rural areas and
patient access to dermatological nurses.
Prince Edward Island is, by far, in the worst shape. The retirement of the sole dermatologist in that
province means patients must travel outside the province to receive care. Although newly trained
family physicians are helping fill the gap in the short term, two full-time dermatologists are needed
to meet Islanders’ needs.
Currently, no one is shepherding the recruitment of dermatologists in P.E.I. According to the
CSPA’s report card, a potential root cause of the shortage in Atlantic Canada’s smallest province
may be related to remuneration for medical services, which is lower for dermatology than other
medical disciplines.
It’s clear that there is an inherent problem in the health-care system, and the fact that
dermatologists are underpaid in Atlantic Canada is certainly part of it. Fees are much higher in
Alberta, for example, as are cosmetic services compared to clinical services.
Dermatologists aren’t compensated for triaging high-priority cases and seeing them urgently, but
we do so because we’re physicians and we care about our patients. Even though the system can be
frustrating, we must continue putting patients first.
Editorial Board/
Conseil de rédaction
Regional Editors /
Rédacteurs régionaux
National Editor/
Rédacteur en chef
Benjamin Barankin, MD
Toronto, ON
Charles W. Lynde, MD
Markham, ON
Marc Boucier, MD
Moncton, NB
Executive Director /
Directeure générale
Peter R. Hull, MD
Saskatoon, SK
Chantal Courchesne
Ottawa, ON
Statements and opinions expressed in the CDAeB
reflect the opinions of the authors and not necessarily
the CDA. The CDA does not assume responsibility or
liability for damages arising from errors or omissions,
or from the use of information or advice contained in
the CDAeB articles or letters.
Les textes et les opinions publiés dans le eBACD
reflètent les points de vue de leurs auteurs et non pas
nécessairement ceux de l’ACD. L’ACD ne peut être
tenue responsable des dommages qui pourraient résulter d’erreurs ou d’omissions rélées à l’utilisation de
renseignements ou de conseils inclus dans les articles
ou lettres apparaissant dans le eBACD.
Robert Jackson, MD
Ottawa, ON
Ian Landells, MD
St. John’s, NL
Catherine McCuaig, MD
Montréal, QC
Kathleen Moses, MD
Ottawa, ON
Paul Kuzel, MD
Edmonton, AB
G. Daniel Schachter, MD
Toronto, MD
Victoria Taraska, MD
Winnipeg, MB
Catherine Zip, MD
Calgary, AB
The Canadian Dermatology Association eBulletin is issued
monthly as a forum for Association News, information of
interest to members and for members’ opinions. Please notify
the Executive Director of any change in address.
L’Association canadienne de dermatologie publie chaque mois
le eBulletin en tant que forum de nouvelles de l’Association,
d’informations qui pourraient intéresser nos membres, ainsi
que pour recueillir leurs opinions. Prière d’aviser la Directeure
générale pour tout changement d’adresse.
CHANTAL COURCHESNE
EXECUITVE DIRECTOR / DIRECTEURE GÉNÉRALE
425-1385 rue, Bank Street, Ottawa, ON K1H 8N4
Tel: (613) 738-1748 / 1-800-267-3376 | Fax: (613) 738-4695
[email protected]