04.Are you better off with a GP
So are you better off seeing your GP for a skin check, and giving skin cancer clinics a miss? Here are some things to consider:
- Reports of overservicing in skin cancer clinics can certainly be alarming. Australian researchers in 2006 found that doctors in skin cancer clinics were cutting out almost 29 moles for every melanoma they picked up.
- They were also performing expensive and over-complicated skin flap repairs — where nearby skin is moved to cover the area where a lesion was cut out — at up to three times the rate of dermatologists and specialist surgeons.
- Research from Queensland published later that year, however, found that skin clinic doctors have a high success rate at identifying a wide range of benign skin markings, and moderate to high success identifying cancer.
- Another Australian study published last year found that GPs and skin cancer clinic doctors diagnose skin cancer with similar accuracy.
- The same study found that skin clinic doctors are more likely than regular GPs to have had additional training in skin cancer, conduct whole-body skin examinations and use specialised equipment such as computer imaging to assist their diagnosis. Any equipment is simply a tool that assists in making a diagnosis, however — the quality of the diagnosis still depends on the experience and skills of the doctor.
As part of a move to raise academic standards and boost credibility, the Skin Cancer Society of Australia and New Zealand, formed in 2005, now offers a Certificate of Skin Cancer Medicine requiring doctors to demonstrate their knowledge and skills in the area.
From Feburary 2008, doctors who obtain the Certificate will be entitled to apply for skin cancer practice accreditation, which requires them to also have good practice systems in place. It may be a year or two, however, before the first doctors receive accreditation, and their details are made publicly available.
When you visit a skin cancer clinic it’s more than likely you’ll receive competent diagnosis and treatment. But as our shadow shop shows, the outcome of a consultation and information given can vary. Use our checklist as a guide to choosing a clinic and what questions to ask. And if you’re not sure of a procedure or diagnosis, get a second opinion.
CHOICE would like the industry to push ahead with self-regulation, to ensure that doctors who choose to work specifically in the area of skin cancer provide the highest standards of clinical care. Meaningful accreditation of skin cancer doctors (not just the clinics) that reflects minimum standards of skin cancer education, skills, training and a code of conduct is vital.