Posted on Mar 24, 2025
Dr Sabrina Nurmohamed, a dermatologist practicing in New Westminster, is tackling the pervasive challenge of long wait times in dermatology with an innovative, team-based approach. Facing a critical backlog, Dr. Nurmohamed recognized the need for a more effective and accessible system.
Her solution? Using the skills of a trained medical photographer to streamline the referral process, thereby expanding her clinic's capacity. Through funding and supports from the Specialist Services Committee (SSC) via the Consultant Specialists Team Care initiative and Shared Care, Dr Nurmohamed’s work is improving the patient and provider experience by addressing timely access to care.
"I treat a large volume of patients and a huge variety of diseases, from babies with eczema to adults with skin cancer," explains Dr Nurmohamed, who says this is an issue for specialists across the province. "Wait times can be extensive, sometimes even reaching a year, especially on the island." This stark reality prompted her to explore alternative models of care delivery. Inspired by similar initiatives in other areas, including the resource-constrained National Health Service in the UK, she implemented a photography-based triage system within her clinic.
This innovative pathway begins when a referring physician suspects a patient may have skin cancer. Instead of waiting months for a traditional in-person consultation, the patient is booked for a prompt appointment with Dr Nurmohamed’s trained medical photographer within a week or two. During this session, standardized photographs of the concerning skin lesion are taken, along with precise measurements and a brief patient questionnaire about the lesion’s history and symptoms. A specialized lens provides the unique view of a dermatoscope – a tool she describes as her "sixth sense" – and captures detailed images of the skin's surface.
These images, along with the other collected information, are then reviewed by Dr Nurmohamed. "This information comes into my system just like a lab result," she explains. "I'm able to assess the lesion remotely and determine the next steps." This could range from reassurance and discharge for benign lesions to recommendations for further investigation, biopsy, or direct referral to surgery.
The impact of this streamlined approach has been very impressive. The photographer can see an additional 30 patients per clinic day, effectively doubling the capacity on those days. Remarkably, approximately half of the patients referred through this pathway can be safely discharged after the initial photographic assessment, freeing up valuable in-person appointment slots for more complex or urgent cases.
"This simple idea enables rapid diagnosis of skin cancers, enhances dermatology productivity, and reduces waitlists across all skin disorders" says Dr Nurmohamed. In a recent six-month period, several early-stage melanomas were detected through this approach, underscoring the life-saving potential of early detection and timely intervention.
Dr Nurmohamed is committed to expanding her innovative model of dermatological care beyond her clinic, aiming to address gaps in traditional approaches. She has shared her findings at BC Cancer and is actively exploring pilot projects at Urgent and Primary Care Centres (UPCCs), including the Port Moody location. She is also collaborating with a colleague in Nanaimo to implement this practice to address the waitlist backlog and improve care quality for patients. While acknowledging the challenges of shifting from traditional models, Dr Nurmohamed remains optimistic about the potential of this approach to transform dermatological care across BC.
For more information or to express interest in collaborating, please contact Dr Nurmohamed at Nurmohamed@spectrumderm.ca.
To learn more about the Consultant Specialists Team Care Initiative through the SSC, please contact sscbc@doctorsofbc.ca.
