Perspectives on Dermoscopy in the Primary Care Setting

Natalie M. Williams, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ).
Ashfaq A. Marghoob, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ).
Elizabeth Seiverling, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ).
Richard Usatine, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ).
Darren Tsang, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ).
Natalia Jaimes, From the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL (NMW, DT, NJ); Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (AAM); Division of Dermatology, Maine Medical Center, Portland, ME (ES); Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX (RU); Sylvester Comprehensive Cancer Center, Miami, FL (NJ). njaimes@med.miami.edu.

Abstract

INTRODUCTION: Dermoscopy is a noninvasive, in vivo imaging technique that allows for the visualization of subsurface skin structures. In recent years, several education interventions have incorporated dermoscopy in the primary care setting to improve skin cancer detection. We aim to describe the perspectives, attitudes, and interest of primary care physicians (PCPs) regarding dermoscopy. METHODS: PCPs associated with academic institutions completed an anonymous survey emailed to faculty and resident listservs. The survey consisted of 23 questions related to dermoscopy. RESULTS: A total of 156 PCPs completed the questionnaire. Few PCPs reported having access to a dermatoscope (16%), using it regularly (9%), or having received training (15%). The most common reasons for not using a dermatoscope were the lack of access to the device (85%), followed by the lack of training (76%). However, the majority view dermoscopy as a valuable tool in primary care and are interested in receiving training (87%), particularly with a hands-on approach. CONCLUSION: Our sample of PCPs in the United States showed that although few use dermoscopy, most perceive it as a useful tool, particularly family medicine physicians. The main reported barriers preventing its use included the lack of training and poor access to dermatoscopes. The vast majority of PCPs in our sample want to be trained in dermoscopy, thereby providing an opportunity for educational initiatives that take into account the barriers and preferred learning strategies.