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 co mprehensive services beyond those offered by dermatologists, Objective : The purpose of this study was to test the hypothesis that dermatolog ists do not meet the standards for providing primary care to which gen eralists are held. Methods: National Ambulatory Medical Care Survey da ta from the year 1995 were used to determine the frequency at which co unseling and preventive examinations were per formed at visits to prim ary care providers and dermatologists. Results: Counseling and prevent ive examinations were performed at a minority of visits for skin disea se. No counseling was reported at 91% of the visits to primary care pr oviders and at 94% of visits to dermatologists. Preventive examination s other than blood pressure were done at 4.7% of the visits to primary care providers and at 1.5% of visits to dermatologists. Conclusion: T he 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.