Editor—Salisbury et al have provided evidence that community dermatology, delivered by a general practitioner with a special interest, is accessible, well liked by patients, and effective.1 This comes as no surprise to those of us working in this service. However, I was unable to understand how Coast et al found it to be nearly twice as expensive for the NHS as hospital outpatient care.2 I cannot refute the findings of this particular study, as the …