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Dermatology in Germany

J Barth

    The Journal of Dermatology
    |February 17, 1999
    PubMed
    Summary
    This summary is machine-generated.

    German dermatology, a field with a long tradition, encompasses diverse specialties. A discussion is underway to potentially alter the patient referral system, which dermatologists aim to prevent.

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    Area of Science:

    • Medical specialization
    • Dermatology
    • Germany

    Background:

    • Dermatology in Germany has a rich history, with university departments established approximately 120 years ago.
    • Historically, venerology was integrated into dermatology, and the field now encompasses andrology, allergy, medical cosmetology, mycology, dermatosurgery, phlebology, and photodermatology.
    • This broad scope increasingly leads to competition with other medical disciplines.

    Purpose of the Study:

    • To analyze the structure and patient access within German dermatology.
    • To examine the current landscape of dermatological practice in Germany.
    • To understand the ongoing debate regarding the role of general practitioners (GPs) as gatekeepers in dermatology.

    Main Methods:

    • Statistical analysis of dermatologist distribution and patient-to-dermatologist ratios in Germany (1997 data).

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  • Description of the organizational structure of dermatological practices versus clinical employment.
  • Analysis of patient referral patterns, contrasting direct access to dermatologists with GP gatekeeping models.

    • Main Results:

    • In 1997, approximately 77% of German dermatologists (3281 out of 4240) worked in private practices.
    • Dermatologists constituted about 1.5% of all physicians in Germany, with a ratio of 1 dermatologist per 20,000 people.
    • The majority of patients directly access dermatologists, bypassing general practitioners (GPs), who represent about 40% of German physicians.

    Conclusions:

    • German dermatology is a well-established and comprehensive specialty.
    • The direct patient access model in dermatology is a significant advantage.
    • Dermatologists are actively working to preserve the broad scope of their specialty and prevent the implementation of a GP gatekeeper system.