What do general practitioners want from a dermatology department?

Four hundred and fifty-six practitioners (GPs) in Avon were asked what they required from their department of dermatology, and what improvements to the present service they could suggest. Most GPs preferred to manage the majority of dermatological problems themselves, with support from the department where necessary. They referred to a hospital department because they lacked the necessary expertise, but would prefer to receive training, advice and support in managing their patients rather than surrender long-term care to a specialist department. Despite this expressed willingness to shoulder more of the dermatological burden, only 31% of the GPs had received any postgraduate training in dermatology. In fact 57% said they had little interest in the subject and had not attended any form of dermatology teaching since qualifying. GPs would also like more guidance in the form of regularly updated guidelines and protocols, and easy access to dermatologists for telephone advice at regular fixed times. Some also felt that consultants should aim to provide diagnosis, investigation, and management guidelines for referred patients after a single visit. These findings should prompt a re-appraisal of the relative roles of GP and dermatologist, and emphasize the need for vocational training and continuing medical education in dermatology for all GPs.