BMJ  2005;331 (17 December), doi:10.1136/bmj.331.7530.0-b

GPs with special interests are good but costly

General practitioners with a special interest in dermatology provide a more accessible service than hospital outpatient clinics, while achieving similar clinical outcomes—and are preferred by patients. Salisbury and colleagues (p 1441) randomised nearly 800 patients who were referred to a hospital dermatology clinic with non-urgent conditions to being seen by a general practitioner with a special interest in dermatology or usual hospital outpatient care. In an economic evaluation, Coast and colleagues (p 1444) found that GPs with a special interest were as good as or better than hospital care, but also more costly.

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