Industrialising skin cancer care. JRSM October 2012
The current management of skin cancer in the UK and many countries is based on what might be termed a ‘corner shop’ model. Patients present to their general practitioner (GP) or to a single- handed dermatologist in office practice and either (i) are diagnosed as not needing further treatment because the suspect lesion is benign, (ii) undergo excision of the suspect lesion by their physician or (iii) are referred to an expert (often hospital based) for further diagnosis and surgery if needed. All these consultations are likely very typical traditional ‘medical’ consultations, with a single doctor and patient operat ing in isolation with, to coin a phrase, the patient walking into the consultations room and then ‘shaking hands with their physician’. I suggest that that this traditional model is unnecessarily expensive and likely inferior in quality to a more industrialized model.
Frustratingly I do not have a OA link to this article (written by me). Will see if the editor can send me one— for the moment here is a link JRSM REES to a proof). You should also have a look at Passage to India, written by the journalist Peter Davies in the BMJ.