Patients with skin disease and their relationships with their doctors: a qualitative study of patients with acne, psoriasis and eczema.

OBJECTIVE

To explore the experiences of patients with acne, psoriasis or atopic eczema in their relationships with their treating doctors.

DESIGN

Qualitative study, using semi-structured interviews conducted between January 2004 and April 2005, thematic analysis and modified grounded theory methodology.

SETTING AND PARTICIPANTS

Participants were patients with acne, psoriasis or atopic eczema recruited from urban general practices and urban dermatology practices.

RESULTS

62 semi-structured interviews were conducted. Reports of negative experiences with doctors treating participants' skin conditions were common. Both general practitioners and dermatologists were reported as having poor comprehension of the psychological implications of skin diseases, being insensitive to their patients' emotional suffering, and trivialising participants' disease. Participants acknowledged that time considerations and other pressures may explain these apparent deficiencies. Some participants perceived their doctors as medical technicians and sought treatment for their physical skin disease, not for its emotional or social aspects.

CONCLUSION

We recommend education for GPs about the psychological effects of skin diseases, and education for dermatologists and GPs on how to elicit and manage, or appropriately refer, these problems.