Free Resident-Run Dermatology Clinic Reveals Skin Care Gaps in Urban Uninsured

For patients without health insurance or a regular dermatologist, a stubborn rash or an unexplained mole can go unexamined for months or even years. A new short report in the Archives of Dermatological Research offers a rare, data-driven look at what happens when those patients finally get access to specialist care. Researchers at University Hospitals Cleveland Medical Center analyzed twelve months of intake forms from a monthly, resident-run free dermatology clinic in an urban setting, and their findings sketch a detailed portrait of the skin health needs of an underserved population that is often invisible in the medical literature.

The study, led by dermatology resident Amy Johnson with co-authors Jennifer E. Murphy and Kelly Scarberry, grew out of preliminary observations from several volunteer dermatology events affiliated with an academic hospital. Those early events suggested that certain categories of conditions, notably eczematous dermatitis and disorders of the skin appendages such as hair, nails, and sweat glands, appear disproportionately among people who lack regular dermatologic care or carry inadequate health insurance. Rather than relying on anecdote, the team decided to systematically collect and analyze information from every patient seen at their monthly free clinic over a full year.

The methodology was deliberately simple but thorough. Both patient-completed and provider-completed intake forms were collected at each clinic session and then analyzed to identify recurring patterns. The researchers looked at patients’ zip codes of residence, any history of skin cancer, the most common chief concerns that brought people through the door, the most common clinical findings recorded by providers, and the basic demographics of the patient population. This kind of structured intake analysis is uncommon in the free clinic setting, where documentation is often minimal and follow-up is difficult.

One of the central motivations for the study is the fragmented state of the existing literature. As the authors note, current reports on free dermatology clinics are piecemeal, consisting mostly of individual institutions describing their own clinical experiences. Those reports vary widely not only in the conditions encountered but also in the treatment capabilities available at each site. A clinic that can dispense medications operates very differently from one that can only offer diagnoses and referrals. By publishing a detailed single-clinic analysis, the Cleveland team aims to add a comparable data point that other programs can learn from, even while acknowledging the limits of generalizing from one location.

The authors argue that gathering information from single clinic reports, imperfect as it is, remains valuable because it allows organizers of new or growing clinics to pick and choose the best of all worlds approaches to clinic operations and patient care. If one program demonstrates that a particular triage workflow reduces wait times, or that a certain formulary covers the majority of diagnoses seen, other clinics can adapt those elements without reinventing them. In this sense, the study functions less as a definitive epidemiological survey and more as a practical blueprint built from real-world operational data.

The broader context makes the work timely. A nationwide cross-sectional survey published in the Journal of the American Academy of Dermatology in 2019, cited by the authors, examined access to dermatology services at free medical clinics across the United States and found that specialist care at such facilities is far from guaranteed. A 2024 scoping review in JMIR Dermatology further documented the role of dermatology in student-run clinics nationwide, highlighting both the educational value for trainees and the service gap these clinics fill. The Cleveland clinic adds a resident-run model to this landscape, positioning dermatology trainees as the primary providers under faculty oversight.

Health equity considerations run throughout the report. The authors situate their clinic in Cuyahoga County, Ohio, referencing the county’s 2022 Community Health Needs Assessment, and they cite prior research showing that limited English proficiency is associated with delays in melanoma diagnosis. These references underscore why zip code level analysis matters: mapping where patients travel from can reveal geographic clusters of unmet need and help clinics target outreach. For a specialty in which visual examination of the skin is the core diagnostic tool, barriers to access translate directly into later diagnoses of potentially serious conditions, including skin cancers.

The study also touches on the demographic dimension of dermatologic care, with skin of color listed among the article’s keywords. Dermatologic conditions can present differently across skin tones, and patients from underserved urban communities may face compounded barriers of cost, transportation, language, and a historical lack of trust in the medical system. A free clinic embedded in the community, staffed by trainees who see the same population month after month, offers a mechanism for building continuity of care that episodic volunteer events often cannot provide.

From a technical standpoint, the analysis of paired patient and provider intake forms is a low-cost, reproducible quality improvement tool. Patient forms capture self-reported concerns, insurance status, and demographic information, while provider forms capture clinical impressions and diagnoses, allowing the researchers to compare what patients worry about with what clinicians actually find. Discrepancies between the two can inform patient education efforts, while concordance validates triage assumptions. The authors performed statistical analysis on the collected data, with Murphy generating the tabular summaries included in the manuscript, and Scarberry providing oversight and guidance in study design.

Importantly, the authors are candid about scope. They describe their work as a preliminary, single-institution contribution and explicitly state that no datasets were generated or analyzed beyond the clinic’s own intake records. Yet their aspiration is clear: they hope the data will inform other clinics serving similar patient demographics and enable a more customized, evidence-driven approach to addressing the needs of uninsured and underinsured patients. In a health care system where dermatology remains one of the hardest specialties to access without insurance, even a modest, well-documented clinic analysis can help convert goodwill into measurable, repeatable care.

Subject of Research: Analysis of patient and provider intake data from an urban resident-run free dermatology clinic serving uninsured and underserved populations

Article Title: Analysis of an urban resident-run free dermatology clinic

Article References: Johnson, A., Murphy, J. E., & Scarberry, K. (2026). Analysis of an urban resident-run free dermatology clinic. Archives of Dermatological Research, 318(1), Article 476. https://doi.org/10.1007/s00403-026-04872-5

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04872-5

Keywords: dermatology, free clinic, resident-run clinic, underserved populations, health equity, access to care, eczematous dermatitis, skin of color, urban health, health disparities, skin cancer screening, academic medical center