A review of the resources family doctors use for skin disease education.

For education on dermatology, family practitioners (FPs) primarily turn to journals, textbooks and atlases. Other educational modalities include conferences, CME meetings and the World Wide Web. Dermatologists can target these avenues to better educate FPs on proper skin disease diagnosis and management. In so doing, communication between the two fields will increase, ultimately resulting in better patient care.

A Team Approach

Family practitioners see more cases of skin disease than do dermatologists.1 Though cutaneous disorders account for only a portion of their patient visits, most FPs are skillful in managing several common skin conditions. This may be deceiving, as dermatologists primarily see cases that FPs are unable to treat, prompting specialist referral. We must realize, however, that far more dermatologic cases are being successfully treated by FPs, obviating the need for specialist referral. Ultimately, we only see the small percentage of cases recalcitrant to standard treatment or beyond the scope of a FPs dermatological knowledge.

As specialists, dermatologists receive more training in skin disease diagnosis and treatment than do FPs. Dermatologists are aware of a wider differential and use a more extensive array of treatment options. Therefore, dermatologists can help keep FPs up-to-date and informed about diagnostic and therapeutic trends in skin disease management. By working together, dermatologists and FPs can adopt a team approach to treatment, thereby providing the best possible patient care.

A Review of the Resources FPs Use

To best reach the FP audience, dermatologists can take advantage of printed resources, online resources and meetings that FPs use to learn about dermatology. By being aware of these resources, dermatologists can better reach FPs. We surveyed several FPs to determine what resources they, as a whole, turned toward for dermatological knowledge. It appears that FPs use a wide variety of resources to enhance their knowledge of cutaneous disease (Table 1).

Few journals targeted to FPs routinely cover topics related to skin disease. Among these are the American Family Physician, Journal of Family Physicians and Journal of Family Practice. Partly due to sparse coverage of cutaneous topics in FP journals and partly due to convenience, many FPs turn toward dermatology textbooks and atlases when confronted with questionable skin lesions (Table 1). Furthermore, in our ever-growing, technology-driven world, it was not surprising that many FPs listed conferences, CME meetings and Internet resources as options for obtaining dermatological knowledge. Up-To-Date, an online database of articles dedicated to background, diagnostic and treatment information covering all areas of medicine is used frequently in this respect.

The Value of TeamWork

Taken together, we can look beyond biases and economic forces for the good of our patients. Functioning as a team, FPs and dermatologists can help each other to manage the sizeable caseload of cutaneous disease. FPs who are more informed and more comfortable treating skin disease will reduce the patient backlog of most dermatology practices (more than 3 months in some markets). Most patients will improve faster, rather than having to deal with unsightly, possibly irritating, skin rashes for several months. Specialist referral will instead target patients with difficult, hard-to-manage disorders. Thus, dermatologists are encouraged to make a concerted effort to reach out to FPs and expand their knowledge of our specialty — in doing so, everyone benefits.

Payman Kosari, Ali Alikhan and Dr. Taylor are with the Center for Dermatology Research, Department of Dermatology at Wake Forest University School of Medicine. Dr. Feldman is with the Center for Dermatology Research, Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.

*Both authors contributed equally to this work.