Nonderm accuracy

March 1, 2007

Washington - Family physicians correlate well with dermatologists in diagnosis and treatment of many common skin lesions, a recent study says.

Yet, dermatologists contacted by Dermatology Times say that while this news appears encouraging, the study's authors overstate their results.

Researchers then followed up with patients seven, 28 and 84 days post-treatment to gauge improvement and satisfaction levels.

Though the study's results need replicating, says Dan Merenstein, M.D., director of research programs, department of family medicine, Georgetown University School of Medicine, Washington, and lead author of the study, it "shows us there are about five to 10 lesion types mainly seen - these are the ones general practitioners need to get comfortable with."

They also must know when to refer patients to dermatologists, he says.

A study co-author defends the research against Dr. Fleischer's contention that the work doesn't compare management by nondermatologists to management by dermatologists.

"That's why we had two dermatologists" reviewing cases - to compare how they would have treated cases to family physicians' assessments, counters Robert Phillips, M.D., M.S.P.H., director of the American Academy of Family Physicians' Robert Graham Center, a health policy research center for primary care and family physicians.

Study numbers small

Perhaps more importantly, says Robert Kirsner, M.D., Ph.D., professor and vice chairman, department of dermatology and cutaneous surgery, University of Miami Miller School of Medicine, is that researchers manipulated data in their favor because admittedly they tracked outcomes and satisfaction only of patients whose lesions they expected to improve.