英爵醫美100%皮膚專科醫師團隊，讓您美的放心、美的安心。 

2012年10月16日在美國喬治亞州亞特蘭大市發表了一項新的研究。研究內容指出一般科醫師(包括家醫科及內科)（PCPS）認為皮膚科醫生比起整形外科、耳鼻喉科及眼科醫師更有資格為民眾執行各種皮膚美容及外科手術的治療。然而，一般民眾則比較喜歡找整形外科醫生來做這些治療。

根據奧馬爾 易卜拉欣醫學博士、哲學博士，在康涅狄格皮膚研究所的研究報告，並發表在美國皮膚外科2012年年度會議。這項研究結果也刊登在2012年10月份所發行的皮膚外科雜誌。

在接受WebMD醫學新聞記者採訪時，易卜拉欣博士指出，當涉及到皮膚上的外科手術及美容治療時，人們有一個很大的迷思。他解釋說：「對病人而言，要做什麼治療而找不適合的醫師時是會造成傷害的。而一般科醫師則可以提供正確的資訊給病人並幫助他們了解。」

易卜拉欣博士和他的同事們針對一般科醫師包括家醫科及內科（PCPS）進行了一項網路上的調查。調查指出，在561名受訪者中認為皮膚科醫生最有資格評估和執行包含臉上病變的切片（95％），皮膚癌手術（56％），注射肉毒桿菌毒素（61％），注射填充劑（55％），和執行雷射手術及光療（75％）。

具體來說，當問及一般科醫師誰是最有資格評估和執行臉上病變的切片，548位的受訪者中有521位表示是皮膚科醫師（95.1％），有22位認為是整形外科醫師（3.9％），只有5位表示耳是鼻喉科醫師（小於1.0％）。

同樣，對於是誰最有資格進行皮膚癌手術，307位的受訪者認為是皮膚科醫生（56.0％），219位的受訪者認為是整形外科醫生（39.9％），16位的受訪者認為是耳鼻喉科（2.9％），6位的受訪者認為是眼科醫生（ 1.1％）。

其中女性受訪者比起男性受訪者多達將近1.5倍更願意選擇皮膚科醫生來進行皮膚癌手術。

此外，60％的受訪者說，一個訓練有素的皮膚科醫生且擁有Mohs顯微外科技術是最佳人選。

在選擇施打肉毒桿菌的醫師時，一般民眾有38％選擇皮膚科醫生，而有50％選擇整形外科醫生。相反的約有60％的一般科醫師會選擇皮膚科醫生，而38％選擇整形外科醫生。

在選擇注射填充物的醫師時，差不多有一半的大眾會選擇整形外科醫師，而另一半則選擇皮膚科醫生。相反，近60％的一般科醫師會選擇皮膚科醫生，約40％選擇整形外科醫生。

「一般民眾對於進行美容手術及治療會有選擇整形外科醫師的偏好，雖然這跟我們當初所預期的差別不大」易卜拉希米報告。

在皮膚癌的手術和雷射治療，不管是一般民眾或是一般科醫師都選擇皮膚科醫師執行這些治療。

「並且一般民眾及一般科醫師都不願意由護理師或是醫師助理來執行這些美容手術及治療」，易卜拉欣博士說。

「這些數據反映皮膚科醫生的主導作用，發揮在發展和完善這些程序，每年有將近800萬個皮膚手術和美容手術是由的皮膚科醫生進行（2011年美國皮膚外科學會ASDS皮膚病手術的調查）。一般科醫師認為，皮膚科醫生更能勝任各種皮膚上手術和美容手術」， Dr. Ibrahimi告訴WebMD醫學新聞。

根據易卜拉欣博士在報告中指出，皮膚科是唯一專精於皮膚上各種治療的醫學專業醫生。“調查結果顯示，他們是醫生所選擇的美容醫生，“他說。

康涅狄格州紐哈芬市耶魯大學醫學院的醫學博士David Leffell，認為這個研究的結果其實和過去25年社會上的態度是一致的。

「社會大眾其實並不了解甚麼是專科醫師及專家，在美容這一塊，它其實不只是醫療，他還包括了美容師、外科醫師及皮膚科醫師」

Leffel博士認為一般科醫師有責任讓大眾了解皮膚科醫師及整形外科醫師之間的差異，包含在醫師的培訓經驗，治療成果及費用方面。

對於整形外科及皮膚科醫師之間的混淆其實已經存在一陣子了。事實就是整形外科醫師受過多年的訓練，但絕大多數是與一般外科有關的實習，而不是在皮膚方面的的生物學及生理學。但在整形外科之中，又有所謂的顏面整形外科，所以不只是社會大眾，連許多一般科醫師也都被混淆了。

Leffell博士又解釋到，整形外科醫師經過多年的努力來證明他們在整形方面的技術。但是有各科醫師都來從事整型這方面的技術，所以又讓社會大眾更困惑了。

“我的觀點是，培訓背景並不重要，重要的是具備技能和判斷力的醫生，這對一般消費者來說會持續是個挑戰，直到醫界有更多醫學美容治療的報告及結果。

這項研究是沒有商業資助。研究作者和Leffell博士沒有相關財務關係。

皮膚科外科。2012，38:1645-1651。摘要

美國皮膚外科學會（ASDS）2012年會：會議OA217。發表於2012年10月12日。

資料轉載至Medscape網址http://www.medscape.com

WebMD醫學新聞網站為一整合各類型醫學網路資源之主題網站，主要提供醫師及相關醫療專業人員即時、富含深度、廣度及信度的網路資源，有效蒐集相關資料及節省時間之功能。本網站提供的資訊與服務包括：免費MEDLINE 資料庫檢索、超過250 種的線上繼續教育課程、醫學會議消息、醫學新知及討論群等。

英文原譯:

October 16, 2012 (Atlanta, Georgia) — Primary care physicians (PCPs) believe dermatologists to be more qualified than plastic surgeons, otolaryngologists, and ophthalmologists to perform a variety of cutaneous cosmetic and surgical procedures, according to a new study. However, for some procedures, lay people prefer plastic surgeons over dermatologists.

Omar Ibrahimi, MD, PhD, from the Connecticut Skin Institute in Stamford, presented the study findings here at the American Society for Dermatologic Surgery 2012 Annual Meeting. The findings were also published in the October issue of Dermatologic Surgery.

In an interview with Medscape Medical News, Dr. Ibrahimi noted that there is a great deal of "snake-oilmanship" when it comes to surgical and cosmetic procedures of the skin.

"This is really a disservice to patients because they can be confused about who the best specialist for a particular procedure might be," he said. "We know that primary care physicians serve as the gatekeepers of medicine and are a trusted source of information for their patients, so we felt it was important to objectively assess their perceptions," he explained.

Dr. Ibrahimi and his colleagues conducted a Web-based survey of physicians in primary care, family medicine, and internal medicine training programs (collectively referred to as PCPs). Overall, the 561 respondents identified dermatologists as the most qualified specialist to evaluate and biopsy worrisome lesions on the face (95%), perform skin cancer surgery (56%), inject botulinum toxin (61%), inject fillers (55%), and perform laser procedures (75%).

Specifically, when asked what specialist was most qualified to evaluate and biopsy a worrisome lesion on the skin, 521 of 548 respondents said a dermatologist (95.1%), 22 said a plastic surgeon (3.9%), and 5 said an otolaryngologist (less than 1.0%).

Likewise, for the physician most qualified to perform skin cancer surgery, 307 of the respondents said a dermatologist (56.0%), 219 said a plastic surgeon (39.9%), 16 said an otolaryngologist (2.9%), and 6 said an ophthalmologist (1.1%).

Female respondents were nearly 1.5 times as likely as male respondents to select a dermatologist as the best specialist to perform skin cancer surgery.

Additionally, 60% of the respondents said a fellowship-trained dermatologist was the best physician to perform Mohs micrographic surgery.

For delivery of botulinum toxin, more lay people selected a plastic surgeon (50%) than a dermatologist (38%). In contrast, approximately 60% of PCPs selected a dermatologist and 38% selected a plastic surgeon.

For the delivery of fillers, just under 50% of lay people selected a plastic surgeon, and just under 50% selected a dermatologist. In contrast, nearly 60% of PCPs selected a dermatologist and about 40% selected a plastic surgeon.

"The lay public did have a preference for plastic surgeons, although it wasn't as big a difference as we initially expected," Dr. Ibrahimi reported.

For skin cancer surgery and laser treatments, both lay people and PCPs selected dermatologists more often than plastic surgeons, although lay people were still more likely than PCPs to select plastic surgeons for these tasks.

Both the lay public and PCPs had a low preference for nurse practitioners and physician assistants for any of these procedures, Dr. Ibrahimi said.

"The data reflect the leading role that dermatologists have played in developing and improving many of these procedures, which, taken together with the nearly 8 million surgical and cosmetic procedures dermatologists perform yearly (according to 2011 ASDS Survey on Dermatologic Procedures), is wholly consistent with the very high preferences exhibited by primary care physicians for dermatologists for a variety of surgical and cosmetic procedures of the skin," he told Medscape Medical News.

According to Dr. Ibrahimi, dermatology is the only specialty in medicine where physicians master the medical and surgical management of the skin. "The survey results suggest that they are also the 'doctor's cosmetic doctor'," he said.

The findings are consistent with attitudes in the community over the past 25 years, said David Leffell, MD, from the Yale School of Medicine in New Haven, Connecticut, who was not involved in the study.

"There is a lot of confusion in the patient or consumer community about what specialists do, what qualifies as a specialist, and what the differences are between specialties," Dr. Leffell told Medscape Medical News. "In the area of cosmetic intervention, the spectrum is even broader than for procedures that are clearly medical," he added. "That is, cosmetic skin care runs the gamut from aestheticians to board-certified surgeons and dermatologists."

According to Dr. Leffell, with respect to medical procedures, with accountable care organizations on the horizon and the expectation that PCPs will play a critical role, "it is very important for them to understand the nuanced differences between a dermatologic surgeon and a plastic surgeon, and the difference in training, outcomes, and costs."

"We have known for some time that there is specific confusion about plastic surgeons and dermatologists," he said. "The truth is that plastic surgeons go through extensive training, and their frame of reference is typically general surgery, not the biology and physiology of the skin. Throw into this mix the confusion about 'facial plastic surgeons,' and the public, and even primary care docs, have a right to be confused," he noted.

Dr. Leffell added that plastic surgeons, to their credit, have "worked hard to define their capabilities, and the field of plastic surgery, which is practiced by many different types of doctors, is often confused in the public mind with the specialty of plastic surgery," Dr. Leffell explained.

"My view is that the training background is less important than the skill and judgment of the doctor. That will remain a challenge for the consumer to sort out until there are outcome measures and public reporting for the procedures we perform," he said.

The study was not commercially funded. The study authors and Dr. Leffell have disclosed no relevant financial relationships.

Dermatol Surg. 2012;38:1645-1651. Abstract

American Society for Dermatologic Surgery (ASDS) 2012 Annual Meeting: Session OA217. Presented October 12, 2012.

October 16, 2012 (Atlanta, Georgia) — Primary care physicians (PCPs) believe dermatologists to be more qualified than plastic surgeons, otolaryngologists, and ophthalmologists to perform a variety of cutaneous cosmetic and surgical procedures, according to a new study. However, for some procedures, lay people prefer plastic surgeons over dermatologists.

Omar Ibrahimi, MD, PhD, from the Connecticut Skin Institute in Stamford, presented the study findings here at the American Society for Dermatologic Surgery 2012 Annual Meeting. The findings were also published in the October issue of Dermatologic Surgery.

In an interview with Medscape Medical News, Dr. Ibrahimi noted that there is a great deal of "snake-oilmanship" when it comes to surgical and cosmetic procedures of the skin.

"This is really a disservice to patients because they can be confused about who the best specialist for a particular procedure might be," he said. "We know that primary care physicians serve as the gatekeepers of medicine and are a trusted source of information for their patients, so we felt it was important to objectively assess their perceptions," he explained.

Dr. Ibrahimi and his colleagues conducted a Web-based survey of physicians in primary care, family medicine, and internal medicine training programs (collectively referred to as PCPs). Overall, the 561 respondents identified dermatologists as the most qualified specialist to evaluate and biopsy worrisome lesions on the face (95%), perform skin cancer surgery (56%), inject botulinum toxin (61%), inject fillers (55%), and perform laser procedures (75%).

Specifically, when asked what specialist was most qualified to evaluate and biopsy a worrisome lesion on the skin, 521 of 548 respondents said a dermatologist (95.1%), 22 said a plastic surgeon (3.9%), and 5 said an otolaryngologist (less than 1.0%).

Likewise, for the physician most qualified to perform skin cancer surgery, 307 of the respondents said a dermatologist (56.0%), 219 said a plastic surgeon (39.9%), 16 said an otolaryngologist (2.9%), and 6 said an ophthalmologist (1.1%).

Female respondents were nearly 1.5 times as likely as male respondents to select a dermatologist as the best specialist to perform skin cancer surgery.

Additionally, 60% of the respondents said a fellowship-trained dermatologist was the best physician to perform Mohs micrographic surgery.

For delivery of botulinum toxin, more lay people selected a plastic surgeon (50%) than a dermatologist (38%). In contrast, approximately 60% of PCPs selected a dermatologist and 38% selected a plastic surgeon.

For the delivery of fillers, just under 50% of lay people selected a plastic surgeon, and just under 50% selected a dermatologist. In contrast, nearly 60% of PCPs selected a dermatologist and about 40% selected a plastic surgeon.

"The lay public did have a preference for plastic surgeons, although it wasn't as big a difference as we initially expected," Dr. Ibrahimi reported.

For skin cancer surgery and laser treatments, both lay people and PCPs selected dermatologists more often than plastic surgeons, although lay people were still more likely than PCPs to select plastic surgeons for these tasks.

Both the lay public and PCPs had a low preference for nurse practitioners and physician assistants for any of these procedures, Dr. Ibrahimi said.

"The data reflect the leading role that dermatologists have played in developing and improving many of these procedures, which, taken together with the nearly 8 million surgical and cosmetic procedures dermatologists perform yearly (according to 2011 ASDS Survey on Dermatologic Procedures), is wholly consistent with the very high preferences exhibited by primary care physicians for dermatologists for a variety of surgical and cosmetic procedures of the skin," he told Medscape Medical News.

According to Dr. Ibrahimi, dermatology is the only specialty in medicine where physicians master the medical and surgical management of the skin. "The survey results suggest that they are also the 'doctor's cosmetic doctor'," he said.

The findings are consistent with attitudes in the community over the past 25 years, said David Leffell, MD, from the Yale School of Medicine in New Haven, Connecticut, who was not involved in the study.

"There is a lot of confusion in the patient or consumer community about what specialists do, what qualifies as a specialist, and what the differences are between specialties," Dr. Leffell told Medscape Medical News. "In the area of cosmetic intervention, the spectrum is even broader than for procedures that are clearly medical," he added. "That is, cosmetic skin care runs the gamut from aestheticians to board-certified surgeons and dermatologists."

According to Dr. Leffell, with respect to medical procedures, with accountable care organizations on the horizon and the expectation that PCPs will play a critical role, "it is very important for them to understand the nuanced differences between a dermatologic surgeon and a plastic surgeon, and the difference in training, outcomes, and costs."

"We have known for some time that there is specific confusion about plastic surgeons and dermatologists," he said. "The truth is that plastic surgeons go through extensive training, and their frame of reference is typically general surgery, not the biology and physiology of the skin. Throw into this mix the confusion about 'facial plastic surgeons,' and the public, and even primary care docs, have a right to be confused," he noted.

Dr. Leffell added that plastic surgeons, to their credit, have "worked hard to define their capabilities, and the field of plastic surgery, which is practiced by many different types of doctors, is often confused in the public mind with the specialty of plastic surgery," Dr. Leffell explained.

"My view is that the training background is less important than the skill and judgment of the doctor. That will remain a challenge for the consumer to sort out until there are outcome measures and public reporting for the procedures we perform," he said.

The study was not commercially funded. The study authors and Dr. Leffell have disclosed no relevant financial relationships.

Dermatol Surg. 2012;38:1645-1651. Abstract

American Society for Dermatologic Surgery (ASDS) 2012 Annual Meeting: Session OA217. Presented October 12, 2012.