Why This Landed on My Radar
Georgia just rolled out a teledermatology training program that’s putting dermoscopes and minor procedure skills directly into the hands of primary care providers in Swainsboro - one of the most dermatologist-starved regions in the country. This caught my attention because it’s solving a problem every one of us faces: patients who need basic skin checks sitting on three-month waitlists while suspicious lesions evolve. And frankly, this model could be a blueprint for how independent Texas practices start capturing revenue and improving outcomes that we’re currently sending down the road.
Here’s What’s Going On
Augusta University’s Georgia Cancer Center partnered with their Medical College of Georgia dermatology department to launch “Teledermatology Serving Georgia” - a hands-on training program that teaches primary care providers to perform dermatology procedures and screenings they’d normally refer out. They just completed 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 has two arms: clinical teledermatology consults and distance learning for procedures. They’re essentially upskilling PCPs and nurse practitioners to handle the bread-and-butter derm cases - skin cancer screening, basic biopsies, cryotherapy - with remote backup from board-certified dermatologists. The funding comes from their cancer center’s community initiative and the state dermatology society, which tells you the specialists themselves see this as solving a system problem, not encroaching on turf.
Georgia’s overall dermatologist density (3.1 per 100,000) is below the national average, but rural areas like Swainsboro are experiencing a full-blown access crisis. Patients wait months for appointments, drive hours for basic care, and skin cancers that should be caught early are presenting at later stages. The teledermatology model keeps the patient in their medical home while getting specialist-level guidance on diagnosis and treatment.
What This Means for Your Practice
Texas has the same problem, just at a bigger scale. Our rural footprint is massive, and even in the metros, derm appointments are running 6-8 weeks out for non-urgent cases. Your patients with changing moles, actinic keratoses, or suspicious lesions are either waiting too long or not getting seen at all. That’s a clinical risk, but it’s also revenue walking out your door.
Here’s what most of us don’t think about: basic derm procedures are well-reimbursed, don’t require prior auth, and can often be done same-day in a primary care setting. A simple shave biopsy (11300-11313 series) reimburses $150-300 depending on location and size. Cryotherapy for actinic keratoses (17000-17004) is another $200-400. These aren’t huge individual numbers, but if you’re seeing 80-100 patients a week and 10-15% have a derm complaint, that’s real money you’re referring away.
The bigger issue is continuity of care and patient satisfaction. When we refer out for basic derm, we lose control of the timeline, we create fragmentation, and frankly, patients don’t always follow through - especially if they’re underinsured or it means taking another day off work. In Texas, where 18% of the population is uninsured (highest in the nation), that referral often becomes a dead end. The patient goes without care, and you’re left with the liability of a documented suspicious lesion and no follow-up.
No Medicaid expansion makes this worse. Your Medicaid patients can’t get into dermatology at all in most markets. Commercial patients with BCBS Texas or United might get in eventually, but you’re at the mercy of their network and wait times. If you could handle straightforward screening and treatment in-house, you’d be delivering better care and getting paid for it.
Technology and training programs like Georgia’s model show us the path forward. Store-and-forward teledermatology platforms let you photograph a lesion, send it securely to a dermatologist, and get a read within 24-48 hours. You maintain the patient relationship, you bill for the visit and procedure, and the patient gets faster care. The training piece is critical though - most of us haven’t done a shave biopsy since residency, if ever. Structured programs with mentorship and backup make this feasible without the medico-legal anxiety.
Key Takeaways
- Dermatologist shortages are creating 2-3 month wait times even for suspicious lesions - a clinical and liability risk for primary care
- Basic derm procedures (biopsies, cryotherapy) are well-reimbursed, don’t require prior auth, and can be performed in primary care settings with proper training
- Texas’s uninsured population and lack of Medicaid expansion mean many derm referrals result in zero follow-through and untreated disease
- Teledermatology platforms combined with procedural training allow independent practices to capture derm revenue while improving access and outcomes
- Early adopters are building this as a service line differentiator in competitive metro markets and a genuine access solution in rural areas
What Smart Practices Are Doing
Forward-thinking independent groups are partnering with teledermatology platforms and bringing in dermatologists for quarterly hands-on training sessions. They’re credentialing 1-2 providers in basic procedures, blocking derm appointment slots, and marketing skin cancer screening as a same-day service. Some are even billing it as an annual preventive add-on for high-risk patients, creating a recurring revenue stream while genuinely improving outcomes.
Source
“High-Tech Skin Cancer Training Meets Rural Health Care,” Augusta University Jagwire
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