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General practitioners, skin lesions and the new contract
A D Bull1, P B Silcocks, R D Start
1Department of Histopathology, Northern General Hospital, Sheffield.
Journal of Public Health Medicine
|September 1, 1992
Summary
Following a new contract, general practitioners (GPs) removed more skin lesions, but excision completeness decreased. GPs were less likely than surgeons to fully excise both benign and malignant lesions.
Area of Science:
- Dermatology
- Surgical Pathology
- Health Policy
Background:
- General practitioners (GPs) play a crucial role in skin lesion management.
- Changes in healthcare contracts can impact clinical practice and patient outcomes.
- Assessing the completeness of skin lesion excision is vital for preventing recurrence and ensuring accurate diagnosis.
Purpose of the Study:
- To evaluate the impact of a new GP contract on the number and quality of skin lesion excisions.
- To compare the completeness of excision by GPs versus surgeons.
- To identify factors influencing excision completeness in general practice.
Main Methods:
- Retrospective review of skin lesions submitted to a laboratory.
- Comparison of data from a three-month period before and after a new GP contract.
- Analysis of excision completeness for lesions from GPs and surgical specialists.
Main Results:
- A significant increase in skin lesions removed by GPs post-contract introduction.
- Incomplete excision rates were higher for both benign and malignant lesions managed by GPs compared to surgeons.
- Newly trained GPs performing minor surgery showed lower complete excision rates than experienced colleagues.
Conclusions:
- The new GP contract led to an increase in skin lesion removals but a potential decrease in excision quality.
- Further monitoring of skin lesion excisions in general practice is recommended.
- Formation of a joint audit group could improve quality assurance for minor surgical procedures in primary care.