Dermatologists meet the primary care standard for first contact management of skin disease.
BACKGROUND
It has been suggested that first contact for skin disease should be the domain of primary care providers because they provide comprehensive services beyond those offered by dermatologists.


OBJECTIVE
The purpose of this study was to test the hypothesis that dermatologists do not meet the standards for providing primary care to which generalists are held.


METHODS
National Ambulatory Medical Care Survey data from the year 1995 were used to determine the frequency at which counseling and preventive examinations were performed at visits to primary care providers and dermatologists.


RESULTS
Counseling and preventive examinations were performed at a minority of visits for skin disease. No counseling was reported at 91% of the visits to primary care providers and at 94% of visits to dermatologists. Preventive examinations other than blood pressure were done at 4.7% of the visits to primary care providers and at 1.5% of visits to dermatologists.


CONCLUSIONS
The standard of primary care for skin disease, as set by the generalist, is attention to the skin disease and not comprehensive medical care. Dermatologists are best able to meet this standard.
Westwood-Squibb Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA.
S R
SR
Feldman
S R
SR
Peterson
A B
AB
Fleischer
D000293:Adolescent; D000328:Adult; D002648:Child; D003880:Dermatology / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D009819:Office Visits / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000592:standards / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012871:Skin Diseases / Q000175:diagnosis* / Q000517:prevention & control; D014481:United States; D000078329:Workforce