Why This Landed on My Radar
I’ve been watching Georgia’s teledermatology training program because it’s tackling a problem we all face in Texas - especially those of us with rural patient populations. When you’ve got patients driving 90 miles for a suspicious mole check or waiting four months for a derm appointment, you know the system’s broken. What caught my attention is how they’re actually training primary care providers to handle basic dermatology procedures on-site, which could be a game-changer for closing care gaps and generating additional revenue streams.
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 program providing hands-on dermatology training to primary care providers in underserved areas. They recently conducted an intensive training session at East Georgia Healthcare Center in Swainsboro, teaching PCPs and nurse practitioners dermatology procedures they can perform in their own clinics.
The numbers that jumped out at me: Georgia has 3.1 dermatologists per 100,000 people versus the national average of 3.8. But in rural areas like Swainsboro? They’re down to 0.45 dermatologists per 100,000 people. That’s nearly non-existent coverage. The program combines both clinical care support and distance learning to help primary care practices expand their dermatology capabilities without requiring patients to travel or wait months for specialist appointments.
The initiative is funded by the cancer center’s “Unite in the Fight Against Cancer” program and the Georgia Society of Dermatology and Dermatologic Surgery - so there’s actual institutional and specialty society buy-in here, not just grant money that disappears in two years.
What This Means for Your Practice
This Georgia model matters because Texas faces the exact same specialist shortage problem, arguably worse. We’ve got the largest uninsured population in the country, massive rural territories, and our patients are already choosing between paying rent and getting that suspicious lesion checked. When you’re practicing in rural Texas - whether that’s West Texas, the Panhandle, or East Texas - your nearest dermatologist might be a two-hour drive away.
Here’s the revenue reality nobody talks about: every patient you refer out for basic dermatology is lost revenue, and more importantly, it’s a care gap where patients fall through the cracks. They don’t make the appointment. They can’t afford the drive. They wait until that basal cell becomes something worse. Without Medicaid expansion, these patients often have nowhere else to go except the ER when things get serious - and by then, you’re looking at worse outcomes and way higher system costs.
But here’s what’s interesting about the Georgia model: they’re training PCPs to perform procedures we’re actually qualified to do but often don’t because we lack the training or confidence. Simple excisions, biopsies, cryotherapy - these are billable procedures that can be done in a standard primary care visit. For independent practices trying to diversify revenue beyond the E&M treadmill, this is significant.
The teledermatology component also addresses something we’re all dealing with - how do we leverage specialty expertise without losing the patient entirely? Store-and-forward imaging, AI-assisted lesion analysis, and virtual consultations with dermatologists mean you can get expert input while keeping the patient in your care continuum. In Texas, where BCBS and United dominate commercial insurance and both are increasingly demanding care coordination documentation, being able to show you’re managing dermatology concerns in-house strengthens your value proposition.
The bigger strategic question: as value-based care models expand (even in fee-for-service Texas), practices that can handle more in-house are going to have better margins and better outcomes data. Skin cancer is one of the most common cancers we see, and it’s highly treatable when caught early. If you’re in a rural or underserved area, being the practice that can do skin cancer screening and basic procedures makes you stickier with patients and more valuable to any network or ACO arrangement.
Key Takeaways
- Rural Texas faces similar or worse dermatology shortages than rural Georgia - most rural counties have zero dermatologists, creating dangerous care gaps and lost revenue opportunities
- Basic dermatology procedures are within primary care scope and represent an underutilized revenue stream for independent practices willing to get trained
- Teledermatology infrastructure (store-and-forward imaging plus virtual consultations) lets you keep patients in your care while accessing specialist expertise when needed
- Early skin cancer detection is low-hanging fruit for quality metrics - measurable, documentable, and increasingly important for value-based contracts
- Practices that expand procedural capabilities now position themselves better for future value-based arrangements and increase patient retention in competitive markets
What Smart Practices Are Doing
Forward-thinking independent practices are identifying 1-2 providers interested in dermatology and getting them trained through university programs, specialty society workshops, or online platforms offering procedural training. They’re setting up simple dermoscopy equipment and store-and-forward teledermatology platforms to get backup reads from dermatologists when needed, creating a hybrid model that keeps patients in-house while maintaining quality and reducing liability concerns.
Source
“High-Tech Skin Cancer Training Meets Rural Health Care” - Augusta University Jagwire
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