Federman D G, Kirsner R S
Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
Am J Manag Care. 1997 Oct;3(10):1487-92.
Quality of care in medicine has become an increasingly important issue as the nature of healthcare delivery has changed. Many managed care systems rely on the primary care physician to serve as a gatekeeper, thereby limiting access to specialist care. Controversy has arisen regarding the abilities of primary care physicians in one such specialty: dermatology. We reviewed the many studies conducted in the United States evaluating primary care physicians' abilities in dermatology. Despite inherent flaws in many of the studies, one can conclude that primary care providers are inferior to dermatologists in the diagnosis and treatment of skin disease. Whether these process-based data predict outcome is not known.
随着医疗服务性质的改变，医疗质量已成为一个日益重要的问题。许多管理式医疗系统依靠初级保健医生作为看门人，从而限制了获得专科护理的机会。在一个这样的专科领域：皮肤科，关于初级保健医生的能力已经出现了争议。我们回顾了在美国进行的许多评估初级保健医生皮肤科能力的研究。尽管许多研究存在固有缺陷，但可以得出结论，初级保健提供者在皮肤病的诊断和治疗方面不如皮肤科医生。这些基于过程的数据是否能预测结果尚不清楚。
