How dermatology became the 'it' job in medicine

When my primary care doc referred me to a dermatologist for a suspicious mole, I could not find an actual dermatologist who would see me in less than ~8 months. I ended up seeing a physician's assistant, which I'm still uneasy about since there's been a study that shows that PA's seem to have a lower success rate vs. doctors [1], and the educational requirements are very different for PAs.

As a layperson, it seems like we (patients / society) would benefit from having more doctors, i.e. opening up more residency slots and admitting more people to med school, but there's probably a lot I don't understand about the issue. Not sure if it's a lack of political willpower to do this, or if there are other reasons why the number of doctors we train is so restricted.

[1] https://pubmed.ncbi.nlm.nih.gov/29710082/ ("PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists")

I don't think there's necessarily much not understood.

Here in Sweden have almost 2x as many physicians you do, and we pay them about half of what you do, so we end up paying approximately the same in salaries (the average Swedish physician is paid 131k) and I think it works out completely.

We start our training of physicians right after high school, so we push them to get an MSc in Medicine, rather than treating physicians as some kind of pseudo-PhDs, with however requiring head physicians to have an actual PhD; and this system is fine. I think it's the same way in Denmark, and given the stuff they've come up with I imagine one can't complain much about their system.