Waiting time to see a dermatologist in South Africa: A cross-sectional survey.

Abstract

Background: Waiting times for specialist consultations influence timely diagnosis and appropriate disease management. Given the high prevalence and morbidity associated with skin diseases, prolonged waiting times to access dermatological care have important public health implications. In South Africa, data describing waiting times for dermatology services are lacking.

Methods: This descriptive cross-sectional study assessed waiting times for private-sector dermatology services across South Africa. All dermatology practices listed on Medpages were contacted telephonically on three separate occasions between 01 and 31 August 2023. Using a standardised script, appointment availability was requested for a fictitious patient under three clinical scenarios: a routine skin check, a changing pigmented lesion suggestive of possible melanoma and a cosmetic consultation for neurotoxin injection.

Results: A total of 192 dermatologists were included. The national median waiting time was 15 days (interquartile ranges [IQR] 5-48.3 days) for a routine skin check, 5 days (IQR 1-14 days) for suspected melanoma and 12 days (IQR 4-33.8 days) for cosmetic consultation. Waiting times varied widely across provinces, ranging from same-day access to delays exceeding 1 year. The longest median waiting time for routine consultations was observed in the Northern Cape (227 days), while the shortest was in Limpopo (2 days). Consultation fees also showed substantial interprovincial variation.

Conclusion: While overall waiting times appear acceptable at a national level, marked provincial disparities exist. Urgent cases are generally prioritised, yet prolonged delays in certain regions may compromise timely care, underscoring the need for targeted, context-specific interventions.

Contribution: This study provides the first national overview of private-sector dermatology waiting times in South Africa. It highlights significant geographic disparities in access to care within the private healthcare system and generates evidence to inform health service planning, workforce distribution and strategies to improve equitable access to dermatological services.