DERMATOLOGICAL SERVICES PROVIDED TO CHILDREN AND ADOLESCENTS BY PRIMARY-CARE AND OTHER PHYSICIANS IN THE UNITED-STATES

To determine the frequency and types of pediatric dermatologic problem s encountered by primary care physicians, dermatologists, and other ph ysicians, we examined data from the 1990 National Ambulatory Medical C are Survey, a continuing study of physician practice in the United Sta tes. In 1990, 163.3 million physician office visits were made by patie nts 18 years of age or younger for all diagnoses; of these, 126.2 mill ion were to primary care physicians. Among visits to these providers, a primary, secondary, or tertiary cutaneous concern or diagnosis was r ecorded in 12.3 million visits (9.7%). Of these patients with a primar y cutaneous concern, 68% of visits were made to primary care physician s, 21% to dermatologists, and 10% to other physicians. For encounters in which primary care physicians reported a primary dermatologic diagn osis (9.6 million visits, 7.6%), the majority of diagnoses (86-93%) we re in one of five categories: skin infections, dermatitis, parasitic i nfestations, acne, or urticaria. This analysis demonstrates the great frequency with which cutaneous disease occurs in ambulatory medicine, and reinforces the importance of dermatologic education in the trainin g of primary care physicians.