Dermatology referrals in an academic family medicine clinic

Variations in referral rates among primary care physicians have implications for cost and quality of care, as well as primary care training. Dermatology referral rates of residents and faculty from an academic family medicine clinic are described.

Using a computerized referral tracking system, all dermatology referrals from January to March 1999 were retrospectively reviewed. Referral rates were calculated for individual providers, rates of uncompleted referrals were calculated, and reasons for referral were examined.

Residents and faculty made 102 dermatology referrals during the study period. Although no significant differences occurred in referral rates between residents and faculty, significant variation occurred among individual providers. Junior residents had more uncompleted referrals (83%) than senior residents (29%) and faculty. Common skin conditions accounted for most referrals.

Wide variation exists in dermatology referral rates among family medicine residents and faculty. Moreover, many referral appointments are not kept. Family medicine training curricula should include formal education on the referral process.