As doctors cater to looks, skin patients wait

Like airlines that offer first-class and coach sections, dermatology is becoming a two-tier business in which higher-paying customers receive greater pampering. In some dermatologists' offices, free spending cosmetic patients are given appointments more quickly than medical patients for whom health insurance pays fixed reimbursement fees. In other offices, cosmetic patients spend more time with a doctor, and sometimes doctors employ a special receptionist, called a cosmetic concierge, for their beauty patients. Some say the trend creates the message that the cosmetic patient is more important than the medical patient.