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Why Your Dermatologist Is Upselling You on Pricey Procedures You Don’t Need

As wait lists in Ontario grow, some doctors are blurring the line between care and cosmetic treatments

Agnes Ryoo had been trying to get her moles checked out for months. The thirty-two-year-old Toronto resident is Korean Canadian, fair-skinned, and has a smattering of moles all over her body and face. “That combination, plus me being anxious, [means] I’m always afraid of what my moles could become,” Ryoo says. When her family doctor referred her to a dermatologist, she spent a lot of time online looking for clinics that would see her quickly. Just four weeks later, in August 2025, Ryoo saw a dermatologist.

This story was originally published as “When Your Dermatologist Becomes a Salesperson” by our friends at The Local. It has been reprinted here with permission.

She’d hoped the doctor would measure her moles and log them for future monitoring. “That’s all I wanted. And I think that’s the bare minimum of what a derm should be doing—log the symptoms and make note of it for the patient’s future care,” she says. But the dermatologist didn’t seem concerned, Ryoo says, and didn’t investigate the moles that were worrying her, including one particular mole that Ryoo was concerned about. “The doctor was so dismissive,” she recalls.

And then came the sell: the dermatologist told Ryoo that while her mole wasn’t medically concerning, she’d be happy to perform a cosmetic procedure to remove it—and any other moles she wanted—that day for $300 each. Ryoo was shocked. “It was just so obvious she was trying to make a sale,” Ryoo says. “It just felt really disappointing and annoying that a medical conversation was being turned into a sales talk.”

Ryoo is far from the only one who has gone to the dermatologist and experienced the blurring of lines between for-profit cosmetic treatments and medically necessary care. In Canada, the average wait time to see a dermatologist is five months. Ontarians that do go see a dermatologist for a medical issue are sometimes sold a procedure that isn’t covered by the Ontario Health Insurance Plan. At the same time, dermatologists are filling their schedules with cosmetic treatments—Botox, lasers, dermaplaning, removal of non-cancerous moles—making it even harder for people to get an appointment for life-saving dermatological care. It’s a trend that critics warn is creating a two-tier system for dermatological care and may foreshadow what’s to come in Ontario’s health care system more broadly.

When it comes to health care privatization, dermatologists are “the canary in the coal mine because we have such an easy route to privatization,” says Mark Kirchhof, the president of the Canadian Dermatology Association. “I don’t know many dermatology practices now that don’t have a storefront in the office that’s trying to sell you products or don’t offer some sort of cosmetic procedures that are private pay.”

Kirchhof, who is also the head of dermatology at the University of Ottawa and at the Ottawa Hospital, says that one of the major reasons that dermatologists are doing more private pay treatments is the dismal pay that the public system offers them. In 2016, dermatologists were paid $72.15 for a consultation and $21.90 for partial assessments and follow-up e-assessments. Today, a decade later, those rates have not budged.

While OHIP compensation has........

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