Dermatology in Primary Care: Coordination, Prevention, Therapy and Educational Needs
DOI: 10.3238/zfa.2015.0227-0232german translation / full article
Background: Skin diseases are a common reason for consulting family practitioners (FPs). Little is known about the cooperation between FPs and dermatologists. Besides this question we aimed to explore GPs attitudes towards therapy with topical steroids and screening for skin cancer.
Method: Interviews (20–40 min) with 14 FPs using a semi-structured guideline were conducted. Recalling encounters with patients with skin disease, FPs described their individual diagnostic strategies. Interviews were taped and transcribed verbatim. Qualitative analysis was conducted by two independent raters using a deductive-inductive approach.
Results: Regarding the cooperation with the dermatologist, FPs addressed the difficulty to get a timely appointment and the lack of professional feedback. We could identify three different ways how FPs use steroids in daily practice; treatment with topical steroids is normally initiated by the FP. In regard to skin cancer screening FPs showed quite different opinions ranging from total acceptance to strict rejection.
Conclusion: Cooperation between FPs and dermatologists can still be optimized, especially in the fields of communication and division of work. FPs would profit by clear recommendations regarding steroid therapy for common skin diseases. Internationally established approaches like tele dermatology or regular sessions of a dermatologist in FPs’ practices could be established as model projects.