Feldman S R, Peterson S R, Fleischer A B
Westwood-Squibb Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA.
J Am Acad Dermatol. 1998 Aug;39(2 Pt 1):182-6. doi: 10.1016/s0190-9622(98)70071-4.
It has been suggested that first contact for skin disease should be the domain of primary care providers because they provide comprehensive services beyond those offered by dermatologists.
The purpose of this study was to test the hypothesis that dermatologists do not meet the standards for providing primary care to which generalists are held.
National Ambulatory Medical Care Survey data from the year 1995 were used to determine the frequency at which counseling and preventive examinations were performed at visits to primary care providers and dermatologists.
Counseling and preventive examinations were performed at a minority of visits for skin disease. No counseling was reported at 91% of the visits to primary care providers and at 94% of visits to dermatologists. Preventive examinations other than blood pressure were done at 4.7% of the visits to primary care providers and at 1.5% of visits to dermatologists.
The standard of primary care for skin disease, as set by the generalist, is attention to the skin disease and not comprehensive medical care. Dermatologists are best able to meet this standard.
有人认为，皮肤病的首次诊疗应由初级保健提供者负责，因为他们提供的综合服务超出了皮肤科医生的服务范围。
本研究的目的是检验以下假设：皮肤科医生未达到全科医生所遵循的提供初级保健的标准。
使用1995年全国门诊医疗调查数据来确定在初级保健提供者和皮肤科医生处就诊时进行咨询和预防性检查的频率。
在少数皮肤病就诊中进行了咨询和预防性检查。在91%的初级保健提供者就诊和94%的皮肤科医生就诊中未报告进行咨询。除血压检查外的预防性检查在4.7%的初级保健提供者就诊和1.5%的皮肤科医生就诊中进行。
全科医生设定的皮肤病初级保健标准是关注皮肤病，而非全面的医疗护理。皮肤科医生最能达到这一标准。
