GD05 Evaluating access to diverse dermatology providers across socioeconomically distressed communities in the southern USA

Abstract Patient comfort and preference are key aspects of healthcare experiences, particularly in dermatology, where sensitive conditions often require trust and vulnerability. While any qualified dermatology provider can provide high-quality, culturally competent care, research indicates that racial concordance between patients and physicians can enhance satisfaction and foster longer visits (Pandya AG, Alexis AF, Berger TG, Wintroub BU. Increasing racial and ethnic diversity in dermatology: a call to action. J Am Acad Dermatol 2016; 74: 584–7). This study investigates how access to dermatology providers from under-represented racial and ethnic backgrounds varies across socioeconomically distressed communities in the southern USA. This cross-sectional study analysed 122 dermatology clinics in the southern USA. Clinics were identified using the American Academy of Dermatology and MediFind directories, verified through Google Maps and hospital directories, and directly contacted for validation. Clinics were grouped by Distressed Communities Index (DCI) quintiles, from the most prosperous to the most distressed [Economic Innovation Group. Distressed Communities Index (DCI). Available at: https://eig.org/distressed-communities (last accessed 6 March 2025)]. Data on wait times for dermatologists and advanced practice providers (APPs) from under-represented racial and ethnic groups were collected over August 2024. Clinics in less distressed communities with lower DCI scores (0–49.99) had a larger proportion of providers from under-represented racial and ethnic backgrounds (10.6%, 25 of 235) than clinics in more distressed communities (DCI scores 50–100), who had smaller proportions (6.1%, 10 of 164). This may limit opportunities for patients from under-represented racial and ethnic groups seeking culturally or racially concordant care in disadvantaged areas. Notably, dermatologists from minority backgrounds in the second most distressed quintile had significantly longer wait times (93.8 days) than those in other DCI quintiles (7.0–35.7 days; P < 0.001). Interestingly, wait times for racially and ethnically diverse APPs decreased with rising community distress (3.6 days decrease in wait time per increase in DCI quintile, β = −3.61, P < 0.001). Expanding and diversifying the dermatology workforce – including dermatologists and APPs – along with increasing teledermatology services and creating incentives for providers to practise in underserved areas, could help ensure all communities have equitable opportunities to choose care that aligns with their cultural and personal preferences, while maintaining the high-quality care provided by all dermatology professionals.