The DOI matches its Crossref record.
Comparison of dermatologic diagnoses by primary care practitioners and dermatologists: a review of the literature.
Abstract
BACKGROUND: Cost-containment efforts in the United States have led to a greater emphasis on health care delivery by primary care physicians as opposed to specialists, who are assumed to be more costly. With this approach, it is incumbent on the primary care physician to be able to accurately diagnose and treat common maladies, including skin disease. OBJECTIVE: To ascertain whether differences in performance were detectable between groups of physicians when presented with color slides or high-quality transparencies. DESIGN: We performed a critical review of published studies. RESULTS: Overall, dermatologists (93% correct) performed better than nondermatologists (52% correct) (P < .001). No difference was appreciable between dermatology residents (91% correct) and practicing dermatologists (96% correct) or between internal medicine residents (45% correct) and family practice residents (48% correct). In addition, family medicine attending physicians (70% correct) performed better than internal medicine attending physicians (52% correct) (P < .001). CONCLUSION: Primary care physicians should receive more training in the diagnosis of skin disease.
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In the citing paper
“Given limited specialist access in primary care settings where most skin conditions are initially evaluated56,57”
From A Multimodal Vision Foundation Model for Clinical Dermatology (2025) · cites this paper as [57]
In the citing paper
“The diagnostic accuracy of nonspecialists is reportedly only 24% to 70%,4,8,9,10”
In the citing paper
“The examination of some skin conditions by dermatologists results in significantly higher diagnostic accuracy2,3,4 and is associated with better clinical outcomes5 than nondermatologist examination.”
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A deep learning system for differential diagnosis of skin diseases
Liu, Y., Jain, A., Eng, C., Way, D. H., Lee, K., Bui, P., Kanada, K., de Oliveira Marinho, G., Gallegos, J., Gabriele, S., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0842-3 · Cited by 853
Stange, K. C., & Ferrer, R. L. (2009) · The Annals of Family Medicine · doi:10.1370/afm.1023 · Cited by 243
Dermatology in primary care: prevalence and patient disposition.
Lowell, B. A., Froelich, C. W., Federman, D. G., & Kirsner, R. S. (2001) · Journal of the American Academy of Dermatology · doi:10.1067/mjd.2001.114598 · Cited by 231
Self-citationHelfand, M., Mahon, S. M., Eden, K., et al. (2001) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00258-6 · Cited by 186
Metadata
- Authors
- Federman, D. G.
- Affiliations
- Yale University (US)
- Corresponding author
- Federman, D. G.
- ORCID
- Federman, D. G.
- Venue
- Archives of Family Medicine
- Publisher
- CLOCKSS Archive
- Published
- 1999-03-01
- Volume
- 8
- Issue
- 2
- Pages
- 170-172
- ISSN
- 1063-3987 (ISSN-L)
- OpenAlex
- W2072629969
- Cited by
- 136
- References
- 0
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 3 · 2022: 3 · 2021: 9 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 12 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 5 · 2012: 6
- FWCI
- 11.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Education › Innovations in Medical Education
- Keywords
- dermatological diagnosis, primary care physicians, dermatologists, diagnostic accuracy, physician specialty comparison, dermatology residents, family medicine residents, internal medicine residents, cost containment
- MeSH terms
- Clinical Competence, Dermatology, Diagnosis, Differential, Humans, Primary Health Care, Skin Diseases, United States
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