{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:57:13Z","timestamp":1793836633907,"version":"4.6.1"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Dermatol Surg","DS"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Dermatologists are trained in diagnostic and therapeutic procedures for cutaneous lesions, yet comparative trends for basic dermatologic procedures across dermatology providers are lacking at the national level.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE<\/jats:title>\n            <jats:p>To trend common dermatologic procedures among general dermatologists, Mohs surgeons, primary care providers or primary care physicians (PCPs), and nonphysician clinicians (NPCs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Longitudinal analysis of 2016 to 2021 Medicare Public Use Files.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Aggregate dermatologic procedural volume decreased 3.0%. Procedural volume declined among general dermatologists (\u221211.7%), Mohs surgeons (\u221216.7%), and PCPs (\u221241.7%) but increased among NPCs (+57.5%). The <jats:italic toggle=\"yes\">proportion<\/jats:italic> of procedures by general dermatologists decreased substantially for premalignant destructions (\u22126.2%), skin biopsies and shave removals (\u22124.7%), and malignant excisions (\u22124.1%) and more notably in counties that were nonmetro (\u22127.1%), low in income (\u22126.1%), and with &lt;4.0 dermatologists per 100,000 population (\u22127.0%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Aggregate procedural volume decreased across the study period with general dermatologists, Mohs surgeons, and PCPs performing a progressively smaller proportion. The increase in procedures by NPCs may help to address demand but underscores the value of formalized procedural training. The procedural decline by general dermatologists in rural and low-income counties and those with baseline dermatologist shortages may exacerbate existing unmet need. Primary limitation included lack of commercial data.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/dss.0000000000004263","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T13:02:36Z","timestamp":1717592556000},"page":"1017-1023","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Changing Dermatologic Procedural Patterns in the Medicare Population: A National Trend Analysis"],"prefix":"10.1097","volume":"50","author":[{"given":"Christian","family":"Gronbeck","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelesh P.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert E.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Sloan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut;"},{"name":"Department of Dermatology, Department of Veterans Affairs, Newington, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"key":"R1-20250731","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1186\/s12885-022-09940-3","article-title":"Changing trends in the disease burden of non-melanoma skin cancer globally from 1990 to 2019 and its predicted level in 25 years","volume":"22","author":"Hu","year":"2022","journal-title":"BMC Cancer"},{"key":"R2-20250731","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1001\/jamadermatol.2021.3453","article-title":"Inflation-adjusted trends in Medicare reimbursement for common dermatologic procedures, 2007-2021","volume":"157","author":"Mazmudar","year":"2021","journal-title":"JAMA Dermatol"},{"key":"R3-20250731","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaad.2022.06.1191","article-title":"Dermatology workforce in the United States - Part I: overview, transformations, and implications","volume":"89","author":"Gronbeck","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"R6-20250731","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1001\/jamadermatol.2019.1514","article-title":"Evaluation of the number-needed-to-biopsy metric for the diagnosis of cutaneous melanoma: a systematic review and meta-analysis","volume":"155","author":"Nelson","year":"2019","journal-title":"JAMA Dermatol"},{"key":"R8-20250731","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/01.JAA.0000470436.69199.45","article-title":"In which states are physician assistants or nurse practitioners more likely to work in primary care?","volume":"28","author":"Hing","year":"2015","journal-title":"Jaapa"}],"container-title":["Dermatologic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/DSS.0000000000004263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T22:01:26Z","timestamp":1753999286000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/DSS.0000000000004263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":5,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/dss.0000000000004263","relation":{},"ISSN":["1076-0512","1524-4725"],"issn-type":[{"value":"1076-0512","type":"print"},{"value":"1524-4725","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,5]]}}}