Beyond the custom and raison d’être of the journal Actas Dermosifilográficas since its founding, this issue includes an original study that examines fees and payment-collection habits in private dermatology practice in Spain.1

In this study, the authors used a survey aimed at dermatologists in private practice to collect data on 234 male and female dermatologists, who make up approximately 10% of the academic members of the Spanish Academy of Dermatology and Venereology in Spain. Although the mean income of health care professionals is quite well known in Spain,2 little or nothing is known about fees per medical intervention or the level of organization in private dermatology practice.

It is interesting to observe, for example, that the mean fee per visit differs depending on the regional section of the respondents, with differences of approximately 30% (from €79.30 in the Valencia section to €109 in the Balearic Islands section). If we look at income per person in each autonomous community, provided by the Spanish National Institute of Statistics, much the same proportionality can be seen.3 It is plausible that fees are adjusted in line with the per capita income of the respective geographical areas.

The most notable datum of this study is the difference in fees by gender; fees for the different clinical and esthetic services are lower for female dermatologists than for male dermatologists. These data remained significant even after adjusting for other variables. With no clear explanation, this fact should, as the authors propose, be the subject of further studies, as these are not salaries in a context where there is a known income gap but rather self-imposed fees.

This study will undoubtedly serve as a point of reference for all those who aim to work providing dermatologic care in the future or for those who are already in practice and who want to have an objective economic view as a means to designing their own personal business projects. Furthermore, as the authors state in the introduction, it is an historical witness to organization and fees in Spanish private dermatology practice in our time.

Finally, this pioneering and innovative study on payment-collection habits and fees may well open the way to determining in the future the impact of fees on care, efficiency, and results in our patients.