National Trends in Mohs Micrographic Surgery: A Decade of Enhanced Access, Improved Tumor Clearance, and Implications for Future Workforce Planning

BACKGROUND: Historically, geographic disparities have reduced access to Mohs surgery across various regions of the United States. OBJECTIVE: To assess nationwide distribution of Mohs surgeons over time, compared to state census data and average number of Mohs stages. MATERIALS AND METHODS: A cross-sectional analysis was performed using the Medicare Public Use Files for 2013 and 2023. RESULTS: From 2013 to 2023, there was an overall national increase (+13.76%) in number of Mohs surgeons per capita. Only District of Columbia (-4.79%), MN (-11.20%), ND (-7.72%), RI (-4.06%), SC (-8.26%), SD (-21.23%), TN (-12.81%), VT (-3.05%), and WV (-9.73%) exhibited decreases in Mohs surgeons per capita. All these experienced either no change or a decrease in Mohs surgeon number while census increased, except for SC, in which population growth outpaced Mohs surgeon number growth. Most states also experienced a decrease in numbers of Mohs stages performed over time. Only HI, ME, and NE exhibited increases in number of stages on all anatomic sites. AL (+1.14%), ID (+6.59%), KS (+0.33%), MS (+7.05%), MT (+2.24%), and UT (+6.71%) exhibited increases in Mohs stages on the trunk/extremities only. CONCLUSION: National per capita access to Mohs surgeons has increased while number of Mohs surgery stages have decreased over the last decade of Medicare data.