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

Letter

Are GPs who specialise in dermatology effective?

Cost calculations were impenetrable

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

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 paper is impenetrable to all but health economists; however, I think it important to point out that dermatology posts for general practitioners with a special interest are not all the same.

I work for Norwich and South Norfolk primary care trusts in two separate clinics. Not only do the doctors have a list, but the specialist dermatology nurse has her own clinic running concurrently. She is able to treat a number of dermatological conditions within . . . [Full text of this article]

Theatre Royal Surgery, Dereham NR19 2QG simon.cooper@nhs.net

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