Leap in skin cancer clinic use24-Nov-2005
by Paul Smith There has been a threefold rise in the proportion of patients opting for treatment at skin cancer clinics rather than traditional GP surgeries, according to preliminary results of a ground-breaking study into the clinics.
With the number of clinics exploding in the past decade, academics have argued they threaten traditional general practice by fragmenting standard care, as well as creaming off more lucrative work from general practice (
Australian Doctor, "Row brews of specialisation?", 22 July).
Some 3600 patients were questioned as part of the Queensland Cancer Fund investigation, which aims to analyse the quality of care offered by the clinics and traditional general practices, and the case mix of patients.
The study found that between 2000 and 2001, 70% of patients visited their GP for detailed skin examination, with 10% opting for skin cancer clinics. But between 2002 and 2004, 54% of patients visited GP surgeries and 31% visited skin cancer clinics.
Professor David Wilkinson, deputy head of the University of Queensland school of medicine, who works one day a week at a Skin Alert clinic and is also researching the clinics, said the rising proportion of patients attending the clinics was most likely because they had greater access to them.
"There are more of them around, and I suspect that is what it reflects," he said.
Professor Wilkinson said the ?jury was still out? on whether the treatment provided by skin cancer clinics was any better or worse than that provided by GPs, but his own research suggested there was ?significant variation? in the care provided by both.
"Some practices are offering the highest quality of care, but some seem to require significant improvement," he said.
The push by some GPs towards specialisation has proved controversial. But Professor Wilkinson said while some GPs had found skin cancer clinics lucrative, he did not believe money was the prime motivator of most GPs adopting specialised practice.
"It is not at the moment an easy, triple-your-income sort of thing," he said. "I think a big factor is clinically, doctors want to develop a particular in-depth knowledge. [Also] There are no after-hours obligations and no weekend obligations."
The Queensland Cancer Fund research into the quality of care provided by clinics and GPs is due to be published next year. It is based on an analysis of 28 skin cancer clinics and 100 GPs working in Queensland.
Source