Abstract
BACKGROUND: The Ontario Health Insurance Plan (OHIP) insures appointments for the assessment and diagnosis of hair loss, or alopecia. Although anecdotal, discussion suggests that, increasingly, dermatologists decline to see referrals of this nature. There has been a lack of objective surveillance to determine the proportion of dermatologists in practice who accept referrals for this concern. OBJECTIVES: This study investigated the proportion of dermatologists in Ontario accepting OHIP referrals for hair loss. Secondary objectives included wait times, consultation fees for non-OHIP visits, and factors affecting referral acceptance or rejection. METHODS: A cross-sectional telephone survey was conducted, in which 284 dermatologists' offices listed by the College of Physicians and Surgeons of Ontario (CPSO) were contacted. The study investigated the acceptance of OHIP referrals for hair loss, wait times, additional referral requirements, and private consultation fees. Descriptive statistics were employed to summarize data. RESULTS: Of the 284 offices contacted, 38.38% (109/284) accepted OHIP referrals for hair loss, 48.59% (138/284) did not, and 13.03% (37/284) were unavailable for contact. The average wait time for offices that accepted referrals was 4.51 ± 4.07 months. Non-OHIP consultation fees ranged from $135 to $299 CAD. Some offices limited acceptance to specific conditions such as alopecia areata and male androgenetic alopecia. CONCLUSION: A total of 48.59% of dermatologists in Ontario do not accept OHIP referrals for hair loss, while the status of 13.03% remains unknown. This reality raises concerns about accessibility to care. Further research is needed to investigate factors influencing referral acceptance.