Care Deficit and Dermatology

June 14, 2022

Dr. Vesta Michelle Warren, AMA President

Dear Members,

Dermatology

Today I am sharing a new issue in the Care Deficit Assessment Series. Issue 5 Dermatology is an interesting example of the care deficit manifesting in specialized care with the potential to affect many patients. To quote the contributors: “As with most health issues, early diagnosis of dermatology-related issues is key to determining the best possible treatment.”
 
The care deficit has severely impacted dermatology patients and has led to dangerous delays in diagnosis and treatment. This has left many Albertans living in pain and, in some instances of skin cancer, these delays in care may shorten lives. Although physicians have been doing all they can to help patients navigate the system and receive the care they need, it is difficult to meet the needs of patients in a timely, effective way.
 
This issue paper illustrates that the care deficit is often more severe than we may expect. Seemingly small deficiencies can pack large punches. For example, an apparently simple condition such as contact dermatitis can impact a patient’s eligibility for certain medical procedures, including surgery for some cardiac procedures that require patch testing before proceeding.
 
Dermatologists have also been called upon to help understand issues such as the pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 infection, which is often difficult to distinguish from Kawasaki disease.
 
There are numerous subspecialties in dermatology such as contact dermatitis testing, wound care, pediatric dermatology, cutaneous lymphoma and immuno-dermatology. Most of these subspecialties are offered by a very small number of physicians. That is why even small changes in access result in significant delays to patient care. Physicians working in these areas have seen their wait times increase from four months to over a year.
 
Alberta’s care deficit is varied, widespread and deep. It will take all of us working together to find a way forward. That’s why the AMA is continuing our public, partner and media advocacy with guidance from the Joint Physician Advocacy Committee.

If your patients are waiting: PatientsFirst.ca

Did you tell a patient today that they have to wait for care? Did you see and try to manage a patient who is struggling or deteriorating because they are waiting? Did your receptionist have to decline a patient or schedule a distant appointment? We want to hear from those patients so that we can measure the extent of the care deficit and its impact on patients. It’s a two-minute stop for them at PatientsFirst.ca.
 
Here is a poster for your office to help spread the word. We will have other materials coming, such as small pads of tear-off sheets for pockets or counters.
 
JPAC will be considering other ways to help physicians participate in this important advocacy. If you have ideas or suggestions to get more physicians and patients involved in PatientsFirst.ca, please let me know!
 
Thanks to the physicians who have begun referring patients to the site. You might be interested to see that patterns are emerging even in the small sample we have used to develop the reporting format. It’s too early to draw conclusions, but this information promises to be illuminating as we work to resolve the care deficit. We expect to report at regular intervals about what Albertans are telling us through the site.
 
I will write again soon. You can reach me any time in the following ways:

  • Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org.
  • Comment publicly on this President’s Letter (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member). 

Sincerely,

Vesta Michelle Warren, MD, CCFP, FCFP
President, Alberta Medical Association

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