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Performance of skin biopsies by general practitioners
L J McWilliam1, F Knox, N Wilkinson
1Department of Pathological Sciences, University Hospital of South Manchester.
BMJ (Clinical Research Ed.)
|November 9, 1991
Summary
General practitioners (GPs) perform more skin biopsies, but hospital doctors achieve higher malignancy diagnosis rates and complete excisions. GPs require enhanced training for skin biopsies to improve patient outcomes.
Area of Science:
- Dermatology
- Surgical Pathology
- Health Services Research
Background:
- An increasing number of skin biopsies are performed by general practitioners (GPs).
- Comparative analysis of GP versus hospital-based surgical performance is crucial for quality assurance.
Purpose of the Study:
- To evaluate and compare the quality of skin biopsies performed by general practitioners against those performed by hospital-based surgeons.
- To assess diagnostic accuracy and completeness of excision in skin biopsies.
Main Methods:
- Retrospective analysis of 292 skin biopsy specimens from GPs and 324 from hospital surgeons.
- Review of clinical and pathological diagnoses and completeness of excision.
- Statistical comparison using chi-squared test.
Main Results:
- The proportion of skin biopsy specimens from GPs increased significantly from 1.3% to 8.7% between 1984 and 1990.
- Malignancy was diagnosed more frequently in hospital cases (19%) compared to GP cases (5%).
- Completeness of excision was significantly lower for GP-performed biopsies (64%) versus hospital-performed biopsies (84%).
Conclusions:
- The rise in minor surgical procedures necessitates adjustments in histopathology department resources.
- Improved training for general practitioners in performing skin biopsies is essential.
- Standardized protocols for specimen submission are recommended to ensure comprehensive examination.