OFFICE-BASED PHYSICIAN SERVICES PROVIDED BY DERMATOLOGISTS IN THE UNITED-STATES IN 1990

Published epidemiologic data regarding dermatologic practice may no lo nger be current. The National Ambulatory Medical Care Survey conducted in 1990 provides a comprehensive assessment of ambulatory medical pra ctice including patient demographics, chief and secondary complaints, diagnoses, and drug treatments prescribed. Many specialties including dermatology were represented in the sampling technique. The database w as reviewed for descriptive aspects of visits to dermatologists survey ed. Using standardized weighting techniques, we estimated the total nu mber of physician visits. Dermatologists had an estimated 24.0 million patient encounters in 1990. Dermatologists treated a disproportionate ly large number of female and younger patients. After adjusting for th eir proportion of the population, Asians and Whites had greater number s of dermatologic encounters than Blacks and Native Americans. Patient s had two or more complaints 27.2% of the time, and received two or mo re diagnoses 28.9% of the time. The most common complaints accounting for 49.7% of visits included ''pimples,'' ''rash,'' ''discoloration,'' ''skin lesion,'' ''wart,'' and ''skin growth.'' The most common diagn oses, accounting for 52.7% of all encounters, were acne, keratosis, wa rt, dermatitis or eczema, benign neoplasm, and malignant neoplasm. Thi s paper presents demographic information, chief and secondary complain ts, and chief and secondary diagnoses of patients visiting dermatologi sts in the United States in 1990. Whites and Asian or Pacific Islander s have increased utilization of services compared with Blacks and Nati ve Americans or Eskimos; this disparity correlates with median family income.