Primary Care-Based Dermatology Practice: Internists Need More Training.
Publication/Presentation Date
1-1-1991
Abstract
OBJECTIVE: To evaluate the ability of teachers in an internal medicine clinic to appropriately diagnose, treat, and refer for specific dermatologic disorders.
DESIGN: Prospective study.
SETTING: Medical school-affiliated primary care clinic.
PATIENTS/PARTICIPANTS: Case presentations of 20 patients who had dermatologic problems were prepared in the form of photographs with accompanying histories. All cases were presented to 17 of 21 available faculty internists who answered questions concerning diagnosis and management of the cases on a questionnaire. The responses of three board-certified faculty dermatologists were used as a reference standard.
MEASUREMENTS AND MAIN RESULTS: The internists had had an average of three weeks' total formal dermatology training. Overall, 60% of cases were correctly diagnosed by the internists and 89% of these were either treated appropriately or referred to dermatologists. In 40% of incorrectly diagnosed cases, internists failed to refer and the majority of these were treated inappropriately. Of referrals deemed appropriate by dermatologists, only 62% were made. Conversely, 33% of referrals were deemed unnecessary.
CONCLUSIONS: Faculty internists were able to diagnose many common skin diseases despite having received little dermatology training. However, errors in diagnosis occurred frequently and when diagnoses were incorrect there was a tendency to mismanage. These data suggest that the current amount of dermatology training is inadequate to prepare future primary care physicians for their increased role in the management of skin disorders.
Volume
6
Issue
1
First Page
52
Last Page
56
ISSN
0884-8734
Published In/Presented At
McCarthy, G. M., Lamb, G. C., Russell, T. J., & Young, M. J. (1991). Primary care-based dermatology practice: internists need more training. Journal Of General Internal Medicine, 6(1), 52-56.
Disciplines
Medical Sciences | Medicine and Health Sciences
PubMedID
1999747
LVHN link
http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=1999747&site=ehost-live&scope=site
Department(s)
Department of Medicine, Department of Medicine Faculty
Document Type
Article