Founder of Toronto dermatology clinic said shortage of dermatologists turning into a ‘crisis’

Every morning outside a dermatology clinic in the Distillery District, dozens of people line up as early as 5 a.m. in the hopes of being seen by a dermatologist that day.

It’s just one of the symptoms of the shortage of available dermatologists in Ontario.

AvantDerm on Mill Street runs one of the only rapid-access clinics in the province. All a patient needs is a referral from a doctor and a health card. A dermatologist sees as many patients as they can, offering 15-minute appointments between 8 a.m. and 11 a.m.

Without the clinic, people would have to wait up to a year or longer in some cities in order to get an appointment.

Dr. Davindra Singh founded AvantDerm after recognizing a need to improve the access patients have to dermatologists. He opened up the rapid access clinic 13 years ago but said it’s never been as bad as it is right now.

“It’s quite horrible … You’ve seen the lineup outside. We can see over 100 people in the morning lineup. We’ve never once advertised it. This is all done by word of mouth.”

Danah arrived at 6 a.m. on Friday and is hopeful she can get to see the dermatologist to have her eczema examined. She said her doctor told her she had to see a specialist in order to be prescribed a cream to help the condition. It’s her second attempt this week.

“I thought it wasn’t going to be that bad. I showed up yesterday at 7:30 a.m. when they open, and the line was too long that they turned people away. So then today we woke up at 5:30 a.m.,” said Danah.

“They have a certain number of people that they can serve a day and after they reach that point. There’s no more room,” she commented.

She lives downtown so it wasn’t too far of a journey, but others come from across the GTA to access the clinic. One man, Balwindar Dhillon, had travelled from Mississauga that morning with no guarantee he would have been seen that day.

Dr. Singh said people have come as far as Vancouver.

“Most of the people we see, probably 20 per cent, are from Kitchener-Waterloo where the waitlist to see a dermatologist is now 18 months. We’ll see people from Ottawa, Kingston, from Windsor. We’ve had someone fly in from Vancouver. This is where they’re coming from,” said Dr. Singh.

“And it’s all because the wait lists are insanely long. And people have acute care needs that need to be met.”

Government mum on possible dermatologist shortage

Adam was first in line on Friday and arrived at 5 a.m. He was directed to the clinic by his family doctor after he had been rejected by two other dermatology clinics. Sylvia, who was also in line, said she had to be there because “the next appointment will be for 2024.”

Dr. Singh said some people don’t have the luxury to wait that long.

“We have people with drug reactions or viral eruptions where the skin seems to be falling off,” explained Dr. Singh. “We’ll have people drive or come six hours for melanoma or something that they think is melanoma. If we don’t see them and then they get diagnosed six months, 12 months later, it would have a huge impact on their life.”

According to the Ontario government, there is only 251 dermatologists for the over 15 million people in the province. As far as Dr. Singh knows, they are the only rapid-access clinic for dermatology in the country.

“It’s like a walk-in clinic for dermatology but imagine it’s more like an urgent care,” said Dr. Singh. “So, it’s kind of high stress, high volume and you need the right people to do it. And it’s not always easy.”

He calls the wait times in the province a “crisis.”

“When I started practicing in dermatology, I think we were averaging two to three months back … This is quadruple if not six times. I don’t think it’s right. I don’t think it’s the way we want to have our healthcare system be and we can’t handle the extra load either.”

The Ministry of Health said the number of dermatologists increased by 5.5 per cent between 2018 and 2021, from 238 to 251, which is above the population growth of 3.6 per cent for the same time period. CityNews asked the ministry if there was a shortage, but they did not answer the question directly.

“If there are people out there listening, we need to help on the supply side. We have to make medical dermatology more attractive to people. We want our dermatologist to be doing more of this to help people,” Dr. Singh said.

“And on the demand side, we really have to help primary care right now … just to help them with this administrative burden, we need to help them actually manage their workload.”