Topical aprepitant in clinical and experimental pruritus.

Comment. While privately insured patients enjoyed a 91% acceptance rate and relatively shorter wait times, the publicly insured patients faced significantly lower acceptance rates and longer appointment wait times. Despite making up less than 20% of the workforce, academic dermatologists provide most of the care for Medicaid patients in Ohio. Not only does this limit access to care for the publicly insured, but it also places significant strain on academic dermatology. In addition, the lower reimbursement, and resulting lower physician compensation, may make it more difficult for academic centers to recruit and retain faculty. The burden faced by academic dermatologists is evident in the data—with an average wait time almost twice that of private dermatologists. With implementation of the health care reform bill and expansion of Medicaid eligibility, longer appointment wait times are inevitable, not only for those with public insurance, but also for those who need the subspecialty care that is often available only at academic centers.