The concept of a General Practitioner with Special Interest (GPwSI) was first proposed in the United Kingdom to help reduce waiting time to see a specialist. In 2015, the National Healthcare Group Polyclinics (NHGP) refer 17.9% of our dermatology attendances to the dermatologist. In 2016, NHGP proposed the “Derm Champ”, a family physician with a special interest in dermatology, to reduce pressure on tertiary dermatology services.
This study aims to find out if Derm Champs can help reduce referrals to the National Skin Centre (NSC).
This is a cross-sectional study from January 2016 to December 2019 where the outcomes of Derm Champ activations were assessed. Data were analysed on the proportion of patients managed in primary care by Derm Champs alone; co-managed with dermatologists via teledermatology or referred to tertiary institutions. The total number of dermatology referrals made from NHGP from 2016-2019 were also extracted.
From January 2016 to December 2019, there were 5,248 Derm Champ activations. 50.8% (n=2,665) of these patients were referred to NSC; 32.8% (n=1,720) were treated in the polyclinic, 4.6% (n=243) were referred to other institutions and 11.8% (n=620) were referred for teledermatology.
2,005 dermatology referrals were avoided after the Derm Champ’s review. This accounts for a 38.2% reduction in dermatology referrals from all cases assessed by the Derm Champ.
Derm Champs can help reduce referrals to the specialists, thereby allowing the dermatologists to focus on more complex cases. The Derm Champ model can be applied to specialties with high referral rates.