BMJ  2006;332:54 (7 January), doi:10.1136/bmj.332.7532.54-a

Letter

Are GPs who specialise in dermatology effective?

High cost of general practitioners with special interests is a fallacy

The first 150 words of the full text of this article appear below.

Editor—The high cost of the service in the articles by Salisbury et al and Coast et al resulted from its failure to attract enough patients to make it economic.^{1 2} A proper, community based skin service relies on accuracy, speed, and a rapid reply to the referring general practitioner, as well as being embedded in the community. I set up such a service in Ealing in 2000, after passing the diploma in practical dermatology, being a clinical assistant, and doing a skin surgery course. It was fully accredited by the British Association of Dermatology and had the support of the local dermatologists.

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Local general practitioners referred patients directly to me by fax. I did three clinics, at three hours each, per fortnight. In 14 months I saw 658 new patients and 498 follow-ups, a total of 1156 consultations. I typed the replies and faxed the letter to the general practitioner that . . . [Full text of this article]

Queens Walk Surgery, London W5 1TP neil.crowley@gp-e85057.nhs.uk

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