Patients' opinions regarding direct access to dermatologic specialty care

Area of Science:

• Dermatology
• Health Services Research
• Patient-Centered Care

Background:

• Managed care systems often limit access to specialty care, including dermatology, due to factors like cost.
• Patient perspectives on these access limitations, particularly for dermatologic conditions, remain under-analyzed.
• Understanding patient preferences is crucial for optimizing healthcare delivery and patient satisfaction.

Purpose of the Study:

• To survey patient opinions on the efficacy, costs, and desirability of gatekeeper-mediated versus direct access to dermatologic specialty care.
• To analyze patient satisfaction levels with generalist versus specialist care for skin conditions.
• To evaluate the perceived importance of direct access to dermatologists.

Main Methods:

• An anonymous survey was administered to 115 patients in an outpatient dermatology clinic.
• Data collected included referral source, prior physician visits, therapy efficacy, and satisfaction with care.
• Patients rated satisfaction with generalist vs. specialist care and the importance of direct access.

Main Results:

• A significant majority of patients (89%) were highly satisfied with dermatologist care, compared to only 24% with previous generalist care.
• Only 6% of patients believed a generalist could adequately treat their skin disease.
• Eighty-seven percent of patients considered direct access to dermatology "very important" for their healthcare.

Conclusions:

• Patients often prefer dermatologic specialists over generalists for managing skin diseases.
• Direct access to dermatologic specialty care is highly valued by patients for perceived efficacy, cost-effectiveness, and time savings.
• Findings suggest a need to reconsider current gatekeeper models for dermatology to align with patient preferences and potentially improve outcomes.