(February 10, 2026) By: Rebecca Gao, The Local<\/p>\n
Getting a mole checked can takes months, but Botox appointments are readily available. Why dermatologists say their practice is the canary in the coal mine for privatized care.<\/em><\/p>\n Agnes Ryoo had been trying to get her moles checked out for months. The 32-year-old Toronto resident is Korean-Canadian, fair-skinned, and has a smattering of moles all over her body and face. \u201cThat combination, plus me being anxious, [means] I\u2019m always afraid of what my moles could become,\u201d Ryoo says. When her family doctor referred her to a dermatologist, she spent a lot of time online looking for clinics that would see her quickly. Just four weeks later in August 2025, Ryoo saw a dermatologist.<\/p>\n She\u2019d hoped the doctor would measure her moles and log them for future monitoring.\u00a0 \u201cThat\u2019s all I wanted. And I think that\u2019s the bare minimum of what a derm should be doing\u2014log the symptoms and make note of it for the patient\u2019s future care,\u201d she says. But the dermatologist didn\u2019t seem concerned, Ryoo says, and didn\u2019t investigate the moles that were worrying her, including one particular mole that Ryoo was concerned about. \u201cThe doctor was so dismissive,\u201d she recalls.<\/p>\n And then came the sell: the dermatologist told Ryoo that while her mole wasn\u2019t medically concerning, she\u2019d be happy to perform a cosmetic procedure to remove it\u2014and any other moles she wanted\u2014that day for $300 each. Ryoo was shocked. \u201cIt was just so obvious she was trying to make a sale,\u201d Ryoo says. \u201cIt just felt really disappointing and annoying that a medical conversation was being turned into a sales talk.\u201d<\/p>\n Ryoo is far from the only one who has gone to the dermatologist and experienced the blurring of lines between for-profit cosmetic treatments and medically necessary care. \u00a0In Canada, the average wait time to see a dermatologist is five months. Ontarians that do go see a dermatologist for a medical issue are sometimes sold a procedure that isn\u2019t covered by OHIP. At the same time, dermatologists are filling their schedules with cosmetic treatments\u2014Botox, lasers, dermaplaning, removal of non-cancerous moles\u2014making it even harder for people to get an appointment for life-saving dermatological care. It\u2019s a trend that critics warn is creating a two-tier system for dermatological care, and may foreshadow what\u2019s to come in Ontario\u2019s health care system more broadly.<\/p>\n When it comes to health care privatization, dermatologists are \u201cthe canary in the coal mine because we have such an easy route to privatization,\u201d says Dr. Mark Kirchhof, the president of the Canadian Dermatology Association. \u201cI don\u2019t know many dermatology practices now that don\u2019t have a storefront in the office that\u2019s trying to sell you products or don\u2019t offer some sort of cosmetic procedures that are private pay.\u201d<\/p>\n Kirchhof, who is also the head of dermatology at the University of Ottawa and at the Ottawa Hospital, says that one of the major reasons that dermatologists are doing more private pay treatments is the dismal pay that the public system offers them. In 2016, dermatologists were paid $72.15 for a consultation and $21.90 for partial assessments and follow-up e-assessments. Today, a decade later, those rates have not budged.<\/p>\n While OHIP compensation has stagnated, costs for running clinics have skyrocketed.<\/p>\n \u201cDoctors are not immune to inflationary pressures. We still have to pay for offices, we have to pay our staff, we have to pay for materials to run practices,\u201d Kirchhof says. \u201cThis has created an economic disconnect and because of that, dermatology\u2014much like other practices in medicine\u2014have increasingly sought out alternative areas to fund their practice.\u201d<\/p>\n Natalie Mehra, the executive director of public health care advocacy group Ontario Health Coalition, says that the situation with dermatologists is an example of creeping privatization in our health care system. Today, physicians in Ontario routinely charge for services that aren\u2019t explicitly covered under OHIP like doctor\u2019s notes, ear washes, and driver\u2019s medical forms.<\/p>\n \u201cIn recent years, this has run away,\u201d Mehra says, adding that doctors now charge for something as routine as a skin tag removal. But, back in the day, in many specialties \u201cdoctors made enough money and they just covered [these services].\u201d<\/p>\n But if the pressure to find alternative funding paths is felt across all of health care, few areas have more opportunity than dermatologists. \u201cFor dermatologists, it\u2019s easy because we are trained and have experience in cosmetic treatments,\u201d says Kirchhof.<\/p>\n With our culture\u2019s obsession with skin care and looking youthful, as well as the popularity of aesthetic treatments like filler, Botox, and lasers, there\u2019s endless demand for their services. While OHIP pays doctors $53.20 to $143.55 for the excision of pre-malignant lesions and $124.10 for removing malignant melanomas, if you want to remove a mole you simply don\u2019t like the look of, dermatologists can charge whatever they want. There\u2019s a wide range of prices out there\u2014and price varies depending on size and removal process\u2014with some clinics in Toronto charging about $300 per mole on the lowest end and others starting at $600 a mole. Cosmetic mole removal can get up into the thousands.<\/p>\n According to data from The Aesthetic Society, a California-based group of medical professionals who perform cosmetic procedures in Canada and the U.S., more than 5.4 million injectable procedures were performed in these two countries in 2021.<\/p>\n What complicates matters is that in dermatology, Kirchhof says, the line between cosmetic and medically necessary procedures is blurry. Kirchhof points to rosacea, an inflammatory condition that impacts the face and chest and results in redness, flushing, and visible blood vessels. While treatment for inflammatory symptoms\u2014things like bumpiness, pimples, and pustules\u2014is covered by OHIP, the redness that characterizes rosacea is best treated with lasers, which is not covered. \u201cThis might be perceived as an upsell, but really it is what\u2019s medically necessary,\u201d Kirchhof says.<\/p>\n For patients looking for medically necessary care, the wait to see a dermatologist and get treated can be months long\u2014even as lucrative cosmetic procedures like Botox, lasers, and fillers are readily available from a practicing dermatologist. In 2016, researchers from the University of Toronto conducted one of the first population-wide studies of wait times for dermatologists in Ontario. They discovered that while cosmetic appointments had an average wait time of about three weeks, urgent medical appointments had a nine week wait and non-urgent medical appointments saw a 12.7 week wait (that average is higher in rural areas).<\/p>\n Those long wait times can lead to patient dissatisfaction, a reluctance to go to the doctor, and worse outcomes. Andrew Turner says that after waiting months to see a doctor about a mark on his arm in 2009, and then being dismissed immediately, he didn\u2019t want to go back to the dermatologist, even as the mark grew and changed. \u201cI just was not willing to go back and be ignored,\u201d he says.<\/p>\n It wasn\u2019t until over a decade later, in 2021, that Turner saw a dermatologist in Halifax for an unrelated neck mole. The doctor decided to biopsy his arm and diagnosed Turner with stage two amelanotic melanoma, a rare and aggressive skin cancer. According to Turner\u2019s doctor, if they\u2019d waited another year, the melanoma would\u2019ve reached stage four and been fatal. Six months and four surgeries later, Turner was cancer-free.<\/p>\n Things have gotten even worse in the decade since the 2016 study. In March 2025, a new study looked at whether Ontario\u2019s dermatologists accepted referrals for alopecia, or hair loss, consultations, which are covered by OHIP. The study found that nearly half of the dermatologists surveyed did not accept these referrals. The authors of the study hypothesized that the complex nature of an alopecia assessment and the long care path meant that dermatologists are disincentivized to take on these cases.<\/p>\n \u201cGiven the wait lists and given how much selling of medically unnecessary stuff there is to patients, there needs to be more accountability around public wait lists,\u201d Mehra says. \u201cWhy are patients who are in medical need waiting a long time while somebody whose education is highly subsidized by the public is selling medical junk to people who just don\u2019t want to look older?\u201d<\/p>\n So what needs to be done to make dermatological care more accessible for those who need it, without upselling them?<\/p>\n Creating public medical dermatology clinics may be a start, Mehra explains. Since practices are privately-owned, having the government run clinics that mandate a majority of their patients be medical could create more availability for patients who need medical treatment and ensure they won\u2019t have to wait in a queue with those seeking cosmetic treatments.<\/p>\n Advocating for team-based care can also help increase capacity for dermatologists\u2014and it\u2019s already being done in cosmetic settings. Kirchhof explains that in cosmetic clinics, dermatologists have nurses and nurse practitioners who provide treatment alongside them and do the work of following-up after appointments. If that same model of care could be extended to medical practice, \u201cone dermatologist is not just limited by what they can see but they can extend their knowledge and abilities to a larger group of patients,\u201d he says.<\/p>\n And of course, addressing Canada\u2019s doctor shortage will also help lower wait times and increase the number of hands working on medical cases. Right now, there are about two dermatologists for every 100,000 Canadians, lagging behind other countries like the U.S. where there are 3.4 dermatologists for every 100,000 people. Kirchhof says that the Canadian Dermatology Association is lobbying for more dermatologist residency spots to open up\u2014the number of training spots available has been stable for years, despite Canada\u2019s population growth. Incentivizing trained dermatologists to practice and stay in rural areas is also a big concern for his association, since wait times in these parts of the country tend to be exponentially longer than in urban centers. Another solution is to allow more foreign-trained dermatologists into the country, which Kirchhof says the regulatory boards have been pushing for as of late.<\/p>\n Making it easier and cheaper to own a practice is another step forward. Kirchhof says government-backed rent control for medical offices, or a government-owned facility where doctors can buy equipment like sutures at a fixed price, would be able to lower the financial strain on dermatology practices. Increasing OHIP pay and expanding what OHIP covers is also part of incentivizing dermatologists to do more medical procedures. In fact, Kirchhof says more dermatologists performed more medical procedures after Ontario recently introduced a new OHIP billing code that increases the pay to doctors for more complicated procedures or diagnoses.<\/p>\n But in our current health care system, where someone with skin health concerns enters a clinic as both a patient and a customer, the financial incentives for doctors are just not aligned with what\u2019s best for the public. \u201cAt the end of the day, these individuals are running a business and they\u2019re trying to increase cash flow,\u201d Kirchhof says. \u201cPatients obviously have the right to say no, but it\u2019s absolutely a business and people are trying to make money.\u201d<\/p>\n For patients like Agnes Ryoo, trying to get care within that system means either trudging along until the issue is impossible to ignore\u2014like Turner\u2014or finding some alternative way to be treated. Ryoo says she\u2019s now considering medical tourism to address her moles and other dermatological concerns. She\u2019s planning her next trip to South Korea in about a year, where she\u2019ll try to fit in an appointment with a dermatologist. While she acknowledges the drawbacks, like the fact that she won\u2019t be able to transfer patient files to Canada or that dermatologists abroad may still try to sell her unnecessary products and procedures, there\u2019s little to no wait. \u201cYou can just walk into any clinic and you can be seen,\u201d she says. Ryoo will have to pay out of pocket, of course. But for patients in today\u2019s health system\u2014where being a customer may mean quicker and better care than being a patient\u2014that\u2019s no longer a surprise.<\/p>\n Click here for the original article<\/span><\/p>\n","protected":false},"excerpt":{"rendered":" (February 10, 2026) By: Rebecca Gao, The Local Getting a mole checked can takes months, but Botox appointments are readily available. Why dermatologists say their practice is the canary in the coal mine for privatized care. Agnes Ryoo had been trying to get her moles checked out for months. The 32-year-old Toronto resident is Korean-Canadian, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-31227","post","type-post","status-publish","format-standard","hentry","category-ohc-in-the-news"],"yoast_head":"\n