Skin Checks are More Effective when Patients’ Preferences are taken into account

Introduction
–Skin checks occupy a lot of the skin doctor’s time and should be performed on any patient – if possible.
-This allows the dermatologist to know the skin of the patient – and to detect unsuspected sometimes malignant lesions (melanoma, skin cancers) as well as provide more definite diagnosis.
–Many patients ask for a skin check / mole check and this requires examining the patient as a whole. This includes the genital area as well as under the bra…not always feasible in practice.
–This study provides some insights to the patients’ preferences, when conducting a Total Body Examination (TBSE)

Study design
A prospective study was done on 3 different sites (Houston, Texas) which recruited 482 participants of which 443 completed the study (252 male, 191 female)

Results show that:
–A third of Women have gender preferences regarding their dermatologists (33.7%). In contrast only 17% of men have gender preferences. The difference is statistically significant (p lower than 0.001).
–Women prefer to be examined by women dermatologists 99% of the time. More than a third of men prefer to be examined by women dermatologists (37.5%, statistically significant difference (p lower than 0.001)
-Note: Gender preferences in women decrease with age (from 50% of women < 30 years, down to 24.2% of women ≥ 70 years)

–However only 13% of Women request this when scheduling an appointment (Still 4 times more than men, p=0.004)

–When the patient and skin doctor are of the same sex, the patient is more likely to have an examination of the genital area.
-Indeed, when the doctor and patient are of the same gender the doctor ask to remove underwear more than a third of the time (36.9% vs 25.5%, p=0.01). For women, this also translates to a higher probability of examination of the breast area (81.2% vs 71.7%)

Conclusion and comments
-Probably higher quality skin checks when patient and doctor are of the same gender.
-The results depend on the number of dermatologists in a geographical area
-For example, in Geneva, Switzerland, there is a big number of dermatologists – therefore the patients get to do his choice before making the appointment.

Reference: Poster 2981 – Neil AM – Patient preferences during total body skin cancer screening examination. AAD Annual Meeting 2016, Washington DC, USA (United States of America)