U.S. Dermatology Procedures Doubled From 1995-2008

NEW YORK – The number of dermatologic procedures more than doubled from 1995 to 2008, and the average number of procedures done by each U.S. dermatologist jumped by more than 60% in the same period.

The majority of the increase occurred in noncosmetic procedures, which rose from roughly 14 million in 1995 to more than 30 million in 2008, Dr. Steven R. Feldman and his associates reported in a poster at the American Academy of Dermatology’s Summer Academy meeting.

Despite the 62% rise in the average number of procedures per dermatologist, from a mean of 1,111 per physician in 1995 to 1,795 per physician in 2008, the percent of all dermatologic procedures done by dermatologists in 1995-2008 stood at 55%, down from 69% in 1993-1994, said Dr. Feldman, professor of dermatology and director of the Center for Dermatology Research at Wake Forest University in Winston-Salem, N.C.

In contrast, during the same two periods the percent of all dermatologic procedures done by general and family physicians rose, from 15% in 1993-1994 to 19% in 1995-2008.

The different trends seen among dermatologists and other physicians "may be due to a shortage in the dermatology workforce, rather than changes in the general and family physicians’ practices of treating and referring skin conditions," Dr. Feldman and his associates reported.

The analysis used data collected by the Centers for Disease Control and Prevention in the National Ambulatory Medical Care Survey. The researchers tallied cosmetic and noncosmetic dermatologic procedures using ICD-9 codes for the years 1995-2004 and for 2007-2008. They omitted data from 2005-2006 because of ICD-9 coding discrepancies.

During the 12 years included in the calculation, U.S. clinicians performed 298 million total dermatologic procedures in 258 million patients, 56% of them women. Dermatologists performed a majority, 55%, of the procedures, followed by general or family practice physicians, who performed 19%.

The most common procedure was tissue or lesion destruction, 51% of all procedures, followed by biopsies, 15% of the total. Dermatologists dominated as providers for both of these procedures, performing two-thirds of all the destructions and more than three-quarters of the biopsies. Most of the remaining procedures, 27% of the total, included a wide-ranging mix in which each procedure failed to reach even 2% of the total.

Cosmetic procedures constituted 9% of the total, with 42% performed by dermatologists and 26% performed by plastic surgeons. The annual number of cosmetic procedures also roughly doubled during the period studied, rising from about 2 million procedures in 1995 to about 4 million in 2008. The most common cosmetic procedure (and the fifth most common procedure overall) was botulinum toxin injection, a notable achievement given that the Food and Drug Administration’s approval for this use did not occur until April 2002, the investigators noted.

Dr. Feldman said that he has received speaking, consultant, or research support from Abbott, Amgen, Astellas, Aventis, Biogen, Centocor, Connetics, Galderma, Genentech, GlaxoSmithKline (Stiefel), Leo, National Biological, Roche, Warner Chilcott, and 3M.

NEW YORK – The number of dermatologic procedures more than doubled from 1995 to 2008, and the average number of procedures done by each U.S. dermatologist jumped by more than 60% in the same period.

The majority of the increase occurred in noncosmetic procedures, which rose from roughly 14 million in 1995 to more than 30 million in 2008, Dr. Steven R. Feldman and his associates reported in a poster at the American Academy of Dermatology’s Summer Academy meeting.

Despite the 62% rise in the average number of procedures per dermatologist, from a mean of 1,111 per physician in 1995 to 1,795 per physician in 2008, the percent of all dermatologic procedures done by dermatologists in 1995-2008 stood at 55%, down from 69% in 1993-1994, said Dr. Feldman, professor of dermatology and director of the Center for Dermatology Research at Wake Forest University in Winston-Salem, N.C.

In contrast, during the same two periods the percent of all dermatologic procedures done by general and family physicians rose, from 15% in 1993-1994 to 19% in 1995-2008.

The different trends seen among dermatologists and other physicians "may be due to a shortage in the dermatology workforce, rather than changes in the general and family physicians’ practices of treating and referring skin conditions," Dr. Feldman and his associates reported.

The analysis used data collected by the Centers for Disease Control and Prevention in the National Ambulatory Medical Care Survey. The researchers tallied cosmetic and noncosmetic dermatologic procedures using ICD-9 codes for the years 1995-2004 and for 2007-2008. They omitted data from 2005-2006 because of ICD-9 coding discrepancies.

During the 12 years included in the calculation, U.S. clinicians performed 298 million total dermatologic procedures in 258 million patients, 56% of them women. Dermatologists performed a majority, 55%, of the procedures, followed by general or family practice physicians, who performed 19%.

The most common procedure was tissue or lesion destruction, 51% of all procedures, followed by biopsies, 15% of the total. Dermatologists dominated as providers for both of these procedures, performing two-thirds of all the destructions and more than three-quarters of the biopsies. Most of the remaining procedures, 27% of the total, included a wide-ranging mix in which each procedure failed to reach even 2% of the total.

Cosmetic procedures constituted 9% of the total, with 42% performed by dermatologists and 26% performed by plastic surgeons. The annual number of cosmetic procedures also roughly doubled during the period studied, rising from about 2 million procedures in 1995 to about 4 million in 2008. The most common cosmetic procedure (and the fifth most common procedure overall) was botulinum toxin injection, a notable achievement given that the Food and Drug Administration’s approval for this use did not occur until April 2002, the investigators noted.

Dr. Feldman said that he has received speaking, consultant, or research support from Abbott, Amgen, Astellas, Aventis, Biogen, Centocor, Connetics, Galderma, Genentech, GlaxoSmithKline (Stiefel), Leo, National Biological, Roche, Warner Chilcott, and 3M.

NEW YORK – The number of dermatologic procedures more than doubled from 1995 to 2008, and the average number of procedures done by each U.S. dermatologist jumped by more than 60% in the same period.

The majority of the increase occurred in noncosmetic procedures, which rose from roughly 14 million in 1995 to more than 30 million in 2008, Dr. Steven R. Feldman and his associates reported in a poster at the American Academy of Dermatology’s Summer Academy meeting.

Despite the 62% rise in the average number of procedures per dermatologist, from a mean of 1,111 per physician in 1995 to 1,795 per physician in 2008, the percent of all dermatologic procedures done by dermatologists in 1995-2008 stood at 55%, down from 69% in 1993-1994, said Dr. Feldman, professor of dermatology and director of the Center for Dermatology Research at Wake Forest University in Winston-Salem, N.C.

In contrast, during the same two periods the percent of all dermatologic procedures done by general and family physicians rose, from 15% in 1993-1994 to 19% in 1995-2008.

The different trends seen among dermatologists and other physicians "may be due to a shortage in the dermatology workforce, rather than changes in the general and family physicians’ practices of treating and referring skin conditions," Dr. Feldman and his associates reported.

The analysis used data collected by the Centers for Disease Control and Prevention in the National Ambulatory Medical Care Survey. The researchers tallied cosmetic and noncosmetic dermatologic procedures using ICD-9 codes for the years 1995-2004 and for 2007-2008. They omitted data from 2005-2006 because of ICD-9 coding discrepancies.

During the 12 years included in the calculation, U.S. clinicians performed 298 million total dermatologic procedures in 258 million patients, 56% of them women. Dermatologists performed a majority, 55%, of the procedures, followed by general or family practice physicians, who performed 19%.

The most common procedure was tissue or lesion destruction, 51% of all procedures, followed by biopsies, 15% of the total. Dermatologists dominated as providers for both of these procedures, performing two-thirds of all the destructions and more than three-quarters of the biopsies. Most of the remaining procedures, 27% of the total, included a wide-ranging mix in which each procedure failed to reach even 2% of the total.

Cosmetic procedures constituted 9% of the total, with 42% performed by dermatologists and 26% performed by plastic surgeons. The annual number of cosmetic procedures also roughly doubled during the period studied, rising from about 2 million procedures in 1995 to about 4 million in 2008. The most common cosmetic procedure (and the fifth most common procedure overall) was botulinum toxin injection, a notable achievement given that the Food and Drug Administration’s approval for this use did not occur until April 2002, the investigators noted.

Dr. Feldman said that he has received speaking, consultant, or research support from Abbott, Amgen, Astellas, Aventis, Biogen, Centocor, Connetics, Galderma, Genentech, GlaxoSmithKline (Stiefel), Leo, National Biological, Roche, Warner Chilcott, and 3M.