Future of Dermatology / Introduction

In recent years, access to a dermatologist in Belgium has become increasingly challenging. While dermatologists strive to prioritise urgent cases, waiting times of several months have become common for many patients. This situation cannot be explained by a single cause, for instance because of a shortage of dermatologists.

The dermatology community in Belgium performed a structured analysis, supported by surveys, expert discussions, and published research, and identified several interacting root causes1. We wanted to dig into ‘the Why ?’.

Demand for dermatological care has increased significantly, particularly due to citizens’ skin cancer awareness and screening demands. While prevention and early detection remain essential, many consultations concern low-risk patients for whom there is no clear medical or health-related need for specialist care, resulting in substantial (over)use of specialist capacity.

At the same time, the effective clinical availability of dermatologists is declining. Although absolute numbers remain relatively stable, many dermatologists are approaching retirement age, and younger generations tend to work differently, with longer consultations per patient. At the same time, clinical complexity has increased, administrative workload has grown, and expectations regarding work–life balance have evolved.

Finally, structural aspects of how dermatological care is organised and financed limit the efficient use of specialist expertise. Consultation-based reimbursement, limited support for task delegation to trained staff, and insufficient triage mechanisms mean that dermatologists often spend time on activities that could be organised differently or handled at another level of care. At the same time, he current financing framework affects professional engagement in insured care, as reflected in a decreasing proportion of conventioned full-time equivalents (15% in 2024 versus 19% in 2013).

Maximum skin health for all

Together, these factors create a system in which access problems persist despite strong professional commitment and high standards of care. Addressing them requires coordinated, evidence-based action, rather than isolated measures and jumping to conclusions.

In response, the Royal Belgian Society of Dermatology and Venereology launched the Future of Dermatology in Belgium project. The objective was not to assign responsibility, but to translate a shared diagnosis into practical, implementable solutions.

The project was structured around thematic Working Groups, each addressing a key dimension of the access challenge. The following pages present the outcomes of these Working Groups.