TY - JOUR
T1 - Lack of correlation between internists' ability in dermatology and their patterns of treating patients with skin disease
AU - Kirsner, Robert S.
AU - Federman, Daniel G.
N1 - Funding Information:
AcceptedforpublicationApril2, 1996. supported by Dermatology dationClinicalCareerDevelopmentAwardinHealthCare Policy,Correspondingauthor: Robert S. Kirsner, MD, PO BoxEvanston, III. 016250(R-250),DepartmentofDermatology,University ofMiami, Miami, FL 33136.
PY - 1996
Y1 - 1996
N2 - Background and Design: We determine whether a subset of internists exist who are better at diagnosing skin disease and therefore select themselves to treat the majority of patients with dermatologic disorders. A survey was conducted in which internists reported their self-perception regarding their abilities in dermatology, the amount of dermatology training they had received, and the percentage of patients they encounter with and treat for skin diseases. This was correlated with results from an objective photographic (Kodachrome) examination assessing their diagnostic abilities in dermatology. The setting was university and private practices in Miami, Fla, and New Haven, Conn. The participants were general internists, medical subspecialists, and medical residents. After completing a self-administered questionnaire, each physician then participated in an examination where they were shown 20 color photographs of common skin disorders. We correlate the relationship between the survey variables and the results of the photographic examination. Results: Eighty-four internists diagnosed 50.5% of the diseases correctly. Internists perceive themselves as mediocre in dermatology (2.6, on a scale of 1-5, 5 being the best), which correlated with their poor performance on the photographic evaluation (P=.04). Internists reported having limited education or training in dermatology (>85% having < 1 month of training in or after medical school). There was a trend toward a correlation between the amount of training internists received and their ability in dermatology (P=.07). Notably, there was no correlation between internists' ability in dermatology and the percentage of patients they encounter with and treat for skin disease. Conclusions: Internists receive limited training and have resultant poor performance in diagnosing skin disease. Internists are aware of their limited ability in dermatology as demonstrated by their mediocre self-perceived ability. Notably, no correlation was found between internists' abilities in dermatology and the percentage of patients they encounter and treat for skin disease. Therefore, we did not demonstrate a subset of internists, superior at dermatology, who treat the majority of patients with skin disease. This suggests patients with skin disease may be better served by dermatologists.
AB - Background and Design: We determine whether a subset of internists exist who are better at diagnosing skin disease and therefore select themselves to treat the majority of patients with dermatologic disorders. A survey was conducted in which internists reported their self-perception regarding their abilities in dermatology, the amount of dermatology training they had received, and the percentage of patients they encounter with and treat for skin diseases. This was correlated with results from an objective photographic (Kodachrome) examination assessing their diagnostic abilities in dermatology. The setting was university and private practices in Miami, Fla, and New Haven, Conn. The participants were general internists, medical subspecialists, and medical residents. After completing a self-administered questionnaire, each physician then participated in an examination where they were shown 20 color photographs of common skin disorders. We correlate the relationship between the survey variables and the results of the photographic examination. Results: Eighty-four internists diagnosed 50.5% of the diseases correctly. Internists perceive themselves as mediocre in dermatology (2.6, on a scale of 1-5, 5 being the best), which correlated with their poor performance on the photographic evaluation (P=.04). Internists reported having limited education or training in dermatology (>85% having < 1 month of training in or after medical school). There was a trend toward a correlation between the amount of training internists received and their ability in dermatology (P=.07). Notably, there was no correlation between internists' ability in dermatology and the percentage of patients they encounter with and treat for skin disease. Conclusions: Internists receive limited training and have resultant poor performance in diagnosing skin disease. Internists are aware of their limited ability in dermatology as demonstrated by their mediocre self-perceived ability. Notably, no correlation was found between internists' abilities in dermatology and the percentage of patients they encounter and treat for skin disease. Therefore, we did not demonstrate a subset of internists, superior at dermatology, who treat the majority of patients with skin disease. This suggests patients with skin disease may be better served by dermatologists.
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U2 - 10.1001/archderm.132.9.1043
DO - 10.1001/archderm.132.9.1043
M3 - Article
C2 - 8795543
AN - SCOPUS:0029821133
VL - 132
SP - 1043
EP - 1046
JO - A. M. A. archives of dermatology and syphilology
JF - A. M. A. archives of dermatology and syphilology
SN - 2168-6068
IS - 9
ER -