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Quality Assessment of Skin Biopsy Specimens Referred to Anonymous Consultants

Quality Assessment of Skin Biopsy Specimens Referred to Anonymous Consultants Abstract Background and Design: Managed care organizations may direct dermatopathologic specimens to anonymous consultants. I hypothesized that the quality of the consultation decreases when there is no incentive for an anonymous consultant to actively pursue the dermatologist/consumer. Therefore, I examined 364 consecutive specimens that had been directed to anonymous consultants. The specimens were obtained from patients who consulted a university-based dermatology clinic or the office of a collaborating practitioner. The quality of consultation was evaluated in 5 areas: factual correctness, arguable differences in degree, evidence that the history had been read by the consultant, knowledge of dermatologic disease evident in the interpretative aspects of the report, and appropriate direct interaction with the referring physician when indicated. Results: There was concordance between the interpretation by anonymous consultants and the findings of my review in 66.8% of cases that involved common dermatopathologic diagnoses. There were errors in fact in 26 cases (7.1%). There were examples of failure to correlate histologic findings with clinical history, apparent lack of understanding of dermatologic disease, and failure to resolve conflicts between the histologic pattern and the clinical information. Conclusions: I found a decrease in the quality of biopsy specimen interpretation received from anonymous consultants. Dermatologists need to maintain and/or upgrade their skills in dermatopathology to supervise the quality of interpretation obtained from anonymous consultants.Arch Dermatol. 1996;132:1053-1056 References 1. Reeves CA, Bednar DA. Defining quality: alternatives and implications . Acad Manage Rev. 1994;19:419-445. 2. Shaughnessy PW, Crisler KS, Schlenker RE, et al. Measuring and assuring the quality of home health care . Health Care Financing Rev. 1994;16:35-67. 3. McClellan WM, Frederick PR, Helgerson SD, et al. A data-driven approach to improving the care of in-center hemodialysis patients . Health Care Financing Rev. 1995;16:129-140. 4. Lee BD. External quality assessment in histopathology: an overview . J Clin Pathol. 1989;42:1009-1011.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Quality Assessment of Skin Biopsy Specimens Referred to Anonymous Consultants

Archives of Dermatology , Volume 132 (9) – Sep 1, 1996

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1996.03890330067012
Publisher site
See Article on Publisher Site

Abstract

Abstract Background and Design: Managed care organizations may direct dermatopathologic specimens to anonymous consultants. I hypothesized that the quality of the consultation decreases when there is no incentive for an anonymous consultant to actively pursue the dermatologist/consumer. Therefore, I examined 364 consecutive specimens that had been directed to anonymous consultants. The specimens were obtained from patients who consulted a university-based dermatology clinic or the office of a collaborating practitioner. The quality of consultation was evaluated in 5 areas: factual correctness, arguable differences in degree, evidence that the history had been read by the consultant, knowledge of dermatologic disease evident in the interpretative aspects of the report, and appropriate direct interaction with the referring physician when indicated. Results: There was concordance between the interpretation by anonymous consultants and the findings of my review in 66.8% of cases that involved common dermatopathologic diagnoses. There were errors in fact in 26 cases (7.1%). There were examples of failure to correlate histologic findings with clinical history, apparent lack of understanding of dermatologic disease, and failure to resolve conflicts between the histologic pattern and the clinical information. Conclusions: I found a decrease in the quality of biopsy specimen interpretation received from anonymous consultants. Dermatologists need to maintain and/or upgrade their skills in dermatopathology to supervise the quality of interpretation obtained from anonymous consultants.Arch Dermatol. 1996;132:1053-1056 References 1. Reeves CA, Bednar DA. Defining quality: alternatives and implications . Acad Manage Rev. 1994;19:419-445. 2. Shaughnessy PW, Crisler KS, Schlenker RE, et al. Measuring and assuring the quality of home health care . Health Care Financing Rev. 1994;16:35-67. 3. McClellan WM, Frederick PR, Helgerson SD, et al. A data-driven approach to improving the care of in-center hemodialysis patients . Health Care Financing Rev. 1995;16:129-140. 4. Lee BD. External quality assessment in histopathology: an overview . J Clin Pathol. 1989;42:1009-1011.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Sep 1, 1996

References