South Dakota Dermatology: Urban vs Rural Wait Times Survey and Dermatologist Density.

Background: As of 2019, the state of South Dakota had only 32 registered dermatologists, one per 27,569 people. Wait times to be seen for dermatologic care are affected by factors such as socioeconomic status, provider distribution, and patient to provider ratios. This inaccessibility to care or prolonged wait times may lead to diagnosis and treatment delays, and disease progression. We hypothesized wait times to see a dermatologist would be longer in rural areas than urban areas in South Dakota.

Methods: Dermatology clinics throughout South Dakota were contacted to obtain wait times. An internet search was conducted to develop a list of dermatology providers. A population of 50,000 or greater defined an urban area and a ratio of 4 dermatologists per 100,000 people was used as an ideal patient to provider ratio.

Results: Overall, 75% of South Dakota's dermatology clinics participated with an equal rural to urban distribution. There was no statistically significant difference in wait times for new (p=0.787) or established patients (p=0.461) comparing rural and urban clinics. All South Dakota cities with clinics met the goal patient to dermatologist ratio except for Dakota Dunes (included as part of the Sioux City, Iowa metro population).

Conclusions: The data does not support the hypothesis that wait times for dermatologists would be longer in rural locations than urban locations. Despite adequate dermatologist to patient ratios throughout most of South Dakota, wait times of over 6 weeks were found at both urban and rural locations, indicating the need for future studies to assess potential solutions for improving timely access to dermatologic care.