Australian General practitioners' confidence in dermatology diagnosis and management: cross-sectional survey

Abstract

Introduction General practitioner (GP) confidence in management and diagnosis across the range of dermatological conditions has not been well-explored. Objectives This study aimed to document Australian GPs' confidence and its associations in diagnosing and managing dermatological presentations. Methods A cross-sectional questionnaire-based study of Australian GPs. Recruitment was through the restricted Facebook group ('GPs Down Under') and 2022 Royal Australian College of General Practice conference attendees. Items elicited practitioner and practice demographics, dermatology educational experience, and confidence levels in diagnosing and managing 28 dermatological curriculum areas. Results Respondents (n = 278) were most confident in managing eczema, bacterial skin infections, acne, contact dermatitis, and fungal skin diseases. They reported lower confidence for nail disease, connective tissue diseases, vasculitis, vascular tumours and malformations, and cutaneous manifestations of internal diseases. GPs reported greater confidence in managing, as opposed to diagnosing, melanoma and melanocytic lesions, premalignant and malignant keratinocyte skin cancers, sexually transmitted infections, and the skin and viral exanthems. Melanoma and melanocytic lesions, premalignant and malignant keratinocyte skin cancers were perceived as the greatest learning priorities. Conclusions While Australian GPs report high confidence in diagnosing and managing common dermatological conditions, confidence declines for rarer, more complex presentations. Notably, GPs feel more confident in managing skin cancers than diagnosing them, indicating a need for enhanced training in diagnostic skills, particularly dermoscopy. These findings have implications for education delivery.