Five Predictions for the Future of Dermatology

Even before the unprecedented and monumental events of the past 2 years had altered the dermatology landscape, a reshaping of the industry was already underway. The COVID-19 pandemic, however, required those changes to be implemented more quickly, more intensely, and more widely by dermatologists. For instance, a decade ago the COVID-19 pandemic would have been insurmountable from a patient-diagnostic perspective, as we did not have the technology to provide meaningful remote assessments. Because dermatology is primarily a field of visualization, our industry quickly adapted to telehealth services. Patients have reacted extremely favorably to this efficient virtual office visit option,¹ and although nothing can replace in-person treatments, all signs point to continued telehealth uptake and use by modern dermatology practices.²

While we all have seemingly acclimated to this “new normal,” one stark question remains: Where are we headed next? Here are my predictions for the future of the dermatology industry.

1. Remote and Hybrid Work Roles

The growing use of telehealth services has led many dermatology practices to increase the number of remote and hybrid work roles.³ As any practice manager will tell you, a successful dermatology clinic requires a skilled ancillary staff, and the current personnel deficit makes this a big challenge.⁴ Nonclinical employees were often the first to arrive and the last to leave the office. However, the COVID-19 pandemic showed us that allowing remote or hybrid roles for human resource professionals, billing departments, patient scheduling personnel, and advertising/marketing teams can work well for many dermatology practices.⁵ This hybrid modern work model frees up physical clinic space, minimizes unnecessary human contact and thus infection risks, improves employee commute times, offers more patient parking, and allows for a more flexible schedule, all of which ultimately help dermatologists retain top-tier talent. I believe we will see more of these types of roles in the future as well.

2. Degree Inclusivity

Registered nurses, physician associates, and nurse practitioners have stood shoulder to shoulder with physicians on the front lines of the COVID-19 pandemic. The contributions and sacrifices made by allied health care professionals have been significant.⁶ While inclusive practices long ago recognized that physicians alone cannot meet the demand for dermatology care, and already incorporate a variety of health care providers, many traditional dermatology practices now recognize that bringing on other dermatology providers makes economic sense, casts a wider net, and appeals to a more-diverse patient population.⁷

3. Group Practices

The number of multiclinic groups is on the rise in the United States. Mergers and acquisitions, as well as satellite clinics and expanded locations, allow efficient dermatologist partnerships to better address patient demand.⁸ While there are, of course, financial expenditures associated with growth and scaling up, some internal practice components like insurance, electronic health record technology, policies, protocols, social media and marketing resources, accounting, and payroll can be expanded significantly without substantial additional costs. This allows business-minded practitioners to use their current assets to cast a wider net, improve production, and profit in new regions. It is highly likely that as current practitioners retire, the model of a solo dermatologist in a single clinic will be the minority, while group practices will continue to thrive.⁹

4. Educational Opportunities

There was a time where cosmetic procedural training took place during postresidency fellowships, because many dermatology programs lacked robust, hands-on instructional pathways. While fellowships in Mohs micrographic surgery, pediatrics, and dermatopathology still hold immense value, many dermatology residents forgo cosmetic fellowships today.^10,11 Many educational opportunities are available during modern comprehensive residency training and via a multitude of supplemental weekend courses, symposia, manufacturer trainings, and colleague mentorship. Moreover, scientific meetings are great opportunities to earn annual CME credits, network with colleagues, and learn something new. And because the COVID-19 pandemic has caused a significant decline in in-person meetings, virtual meetings are on the rise. They are convenient and offer dermatology providers education from the comfort of their own home or office. In addition, professional dermatological societies can ensure their own growth and development and promote the advancement of the field with substantive content and educational offerings that provide significant value to practitioners.

5. Workplace Well-Being

Job openings are plentiful in the dermatology space, and employees are placing more importance on their financial well-being and mental health. Pay and benefits are improving in response to younger dermatology associates’ determination to seek career opportunities where their welfare is valued. Residents, fellows, and allied health professionals are increasingly viewed as skilled and appreciated members of the patient care team. A positive work-life balance will minimize fatigue and burnout, allowing all practice employees, including the dermatologists, to maximize their full emotional capabilities.¹³

Change is inevitable, and no medical specialty seems to evolve as quickly as dermatology.⁷ The good news is that the industry movements we have recently experienced benefit patients and principled dermatology providers alike. The future will continue to favor those who embrace transformative changes, and a new wave of dermatology providers will lead our great industry to new heights.

1. Naik PP. Rise of teledermatology in the COVID-19 era: a pan-world perspective Digit Health. Published online February 7, 2022. doi:10.1177/20552076221076671

2. Richardson VL, Garcia-Albea VR, Bort NL, Mayne SL, Nolen ME, Bobonich MA. Reflections of COVID-19 on dermatology practice. J Dermatol Nurses Assoc. 2021;13(1):49-53. doi:10.1097/JDN.0000000000000586

3. Rice SM, Siegel JA, Libby T, Graber E, Kourosh AS. Zooming into cosmetic procedures during the COVID-19 pandemic: the provider’s perspective. Int J Womens Dermatol. 2021;7(2):213-216. doi:10.1016/j.ijwd.2021.01.012

4. Glazer AM, Farberg AS, Winkelmann RR, Rigel DS. Analysis of trends in geographic distribution and density of US dermatologists. JAMA Dermatol. 2017;153(4):322-325. doi:10.1001/jamadermatol.2016.5411

5. Minor C. Implementing a long-term remote work strategy: identify criteria, consider multiple models and encourage flexibility. Cleveland Clinic. Published online September 13, 2021. https://consultqd.clevelandclinic.org/implementing-a-long- term-remote-work-strategy

6. About dermatology PAs. Society of Dermatology Physician Assistants. Accessed February 17, 2022. https://www.dermpa.org/page/About_DermPAs

7. Azzawi S. Navigating the evolving landscape of the dermatologic workforce. Cutis. 2021;108(6):E17-E19. doi:10.12788/cutis.0422

8. Theodorakopoulou E, Dalamaga M, Katsimbri P, Boumpas DT, Papadavid E. How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists? Dermatol Ther. 2020;33(3):e13283. doi:10.1111/dth.13283

9. Haberman R, Perez-Chada LM, Merola JF, Scher J, Ogdie A, Reddy SM. Bridging the gaps in the care of psoriasis and psoriatic arthritis: the role of combined clinics. Curr Rheumatol Rep. 2018;20(12):76. doi:10.1007/s11926-018-0785-6

10. Jayakumar KL, Samimi SS. Trends in US dermatology residency and fellowship programs and positions, 2006 to 2016. J Am Acad Dermatol. 2018;78(4):813-815. doi:10.1016/j.jaad.2017.09.072

11. Mulligan KM, Zheng DX, Cullison CR, Wong C, Scott JF. Cosmetic dermatologic surgery fellowship websites and social media presence: opportunities for improved applicant recruitment. J Cosmet Dermatol. 2022;21(1):368-372. doi:10.1111/ jocd.14631

12. Marchalik R, Marchalik D, Wang H, Pasieka H. Drivers and sequelae of burnout in U.S. dermatology trainees. Int J Womens Dermatol. 2021;7(5Part B):780-786. doi:10.1016/j.ijwd.2021.05.001

13. Turner D. COVID-19: The Invisible Impact on Team Members. ODAC. May 8, 2020. Accessed February 17, 2022. https://orlandoderm.org/category/covid-19-resources