Problems more than skin deep

New report calls out Canada on its skin-care record

Colin MacLean
Published on January 30, 2012
Dr. Wayne Gulliver — File photo

According to the Canadian Skin Patient Alliance, Newfoundland and Labrador has failed to provide the level of dermatology care required to meet the needs of patients in this province.

But we’re not alone. In the three major categories used by the alliance to measure success in skin care there was not one passing grade throughout the provinces and territories.

In access to dermatological care: fail. Access to medical procedures: fail. Access to medications: fail.

Diseases profoundly affect the lives of the millions of Canadians

The grades were listed in a new report by the alliance titled Skin Deep: A Report Card on Access to Dermatological Care and Treatment in Canada, which was released last week.

The report is deeply critical of Canada’s state of dermatological care.

“While some provinces deserve some credit for investing in new specialized treatments for skin diseases, the basic needs of skin patients for timely access to appropriate services are not being met. There is great variability among jurisdictions in the quality of services provided,” said the report’s summery.

Christine Janus, executive director of the alliance, added in her statement that it is time governments start taking skin conditions more seriously — if only to save money in the long run.

“Skin diseases are rarely ‘skin deep’ and usually profoundly affect the lives of the millions of Canadians who suffer with them,” said Janus.

 “The mistaken belief that skin conditions are neither serious nor life-threatening must be changed to reflect the reality that they can seriously affect the quality of life of patients, can predispose patients to other debilitating and serious conditions like heart disease and some skin diseases, particularly melanoma and can be fatal.”

There are a handful of areas in the report where it lists Newfoundland and Labrador in need of focusing attention.

—Wait times: patients can face queues of two to 52 weeks for just an appointment to see a dermatologist.

—Drug coverage: according to the report only 31 per cent of funded drugs for skin disease are available without restrictions.

—Rare cases: Newfoundland and Labrador has no policy on rare dermatological disease, which would fund medications for specific patients.

—Nurses: there are 0.1 dermatology nurses in this province for every dermatologist.

It looks bad, and it is, but the situation in this province is not as doom and gloom as the report portrays it, said Dr. Wayne Gulliver, a St. John’s based dermatologist and MUN professor of medicine

“We’re not the best in the country, we’re not the worst,” said Gulliver.

“There is some good news in all this. Even though they believe we failed, we didn’t bomb on all the questions,” he added.

During the research phase of Skin Deep, the alliance consulted with dermatologists from each province and territory, Gulliver was the contacted person from here.

There are 10 dermatologists in Newfoundland and Labrador with another two who have received approval for training, said Gulliver. That means that this province has one of the best dermatologists to patient ratios in Canada. That’s nothing to slouch at given that there are communities in Ontario with 250,000 people with only one skin specialist, he added.

But despite this and a handful of other bright spots, access to skin care in this province still needs work, he said.

Which is where the province comes in.

“In Newfoundland and Labrador there are some aspects of dermatologic care that are very good, wait time ratios, access to medications for certain disease ... In some other aspects of treatment an investment in personnel would certainly decrease wait times and increase access to care, and it would be great it the dermatology community could sit down with government and have an exchange on how we can improve the care,” said Gulliver.

In terms of the report, Gulliver said it is a positive step towards raising the profile of an important area of medicine.

“This is a good thing for dermatology because it gives us some insight into how we’re doing across the country. Overall, by working with the province I think we can really make this a positive specialty and deliver the care that our patients need. So it’s not all doom and gloom,” he said.

A full copy of Skin Deep can be found online at