Why That Three-Month Derm Wait Is Actually a Revenue Opportunity

Primary Care Perspective - Texas Edition | Monday, February 16, 2026

Strategic intelligence for independent primary care physicians in Texas.

Why This Landed on My Radar

I just came across a teledermatology training program in Georgia that’s getting primary care docs comfortable doing basic skin procedures and screenings - and it got me thinking about all those patients on our schedules asking about “this spot” while we’re already running 20 minutes behind. We’re sitting on a clinical skill gap that’s both a patient access problem and an untapped revenue stream, especially for those of us serving rural communities or patients who can’t afford to wait three months for a specialist.

Here’s What’s Going On

Augusta University’s Georgia Cancer Center partnered with their dermatology department to launch “Teledermatology Serving Georgia” - essentially hands-on training for primary care providers to handle basic dermatology procedures and skin cancer screenings. They recently did an on-site training at East Georgia Healthcare Center in Swainsboro, where the dermatologist density is 0.45 per 100,000 people (compared to 3.8 nationally). The program is funded through their cancer center and the Georgia Society of Dermatology, and it combines both clinical care delivery and distance learning.

Here’s the key context: Georgia has 3.1 dermatologists per 100,000 people versus 3.8 nationally, but rural areas get hammered much worse. The result is exactly what we see in Texas - patients waiting months for appointments, driving 100+ miles for basic screenings, or just not going at all. The program trains PCPs to fill that gap with teledermatology support backing them up when they need it.

What This Means for Your Practice

This hits different in Texas because our rural footprint is massive and our access problems are worse. We’ve got 254 counties, and good luck finding a dermatologist within 50 miles in most of them. Even in the metros - Houston, Dallas, San Antonio - the wait times for routine derm appointments are running 8-12 weeks if you’re lucky. And let’s be honest: with the largest uninsured population in the nation and no Medicaid expansion, our patients often can’t afford the specialist visit even if they could get the appointment.

But here’s what caught my attention: skin procedures are actually solid revenue generators for primary care practices, and they’re services our patients genuinely need. We’re talking about simple biopsies, cryotherapy, basic excisions - procedures that take 10-15 minutes and can bill $150-400 depending on complexity and what you find. For independent practices watching margins get squeezed by flat reimbursements and rising overhead, adding dermatology procedures isn’t some side hustle - it’s a legitimate clinical service that improves access and strengthens your bottom line.

The challenge is most of us didn’t get meaningful derm training in residency, and we’re already drowning trying to manage diabetes, hypertension, and prior auths. The Georgia model is smart because it recognizes that primary care doctors need both the procedural training AND the backup of specialists via telemedicine when something looks funky. That’s the gap - not just learning to do a shave biopsy, but having someone to bounce cases off when you’re not sure if that lesion is worth worrying about.

Key Takeaways

• Dermatology access is a crisis in Texas (especially rural areas), creating both a patient need and a revenue opportunity for primary care practices
• Basic skin procedures (biopsies, cryotherapy, simple excisions) are billable, relatively quick, and address a real gap in care
• The barrier isn’t just procedural skills - it’s having specialist backup when you need it, which is where telemedicine models make this scalable
• Practices that can offer basic derm services differentiate themselves, especially in areas where specialist wait times are measured in months
• Early movers capture market share before competitors figure this out or local health systems try to lock it down

What Smart Practices Are Doing

Forward-thinking independent practices are already adding basic dermatology services, particularly skin cancer screenings and simple procedures, with teledermatology partnerships providing the safety net. They’re marketing it directly to patients tired of waiting months for specialist appointments and positioning it as comprehensive primary care that actually addresses what patients walk in asking about.

Source

High-Tech Skin Cancer Training Meets Rural Health Care, Augusta University Jagwire

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