10 years quality assurance of the dermatologist's procedure. ABD review board part II: 2003-2009

Abstract

Background: The dermatologist's procedure (''procedure for early detection of occupational skin diseases'') enables dermatologists to conduct the relevant diagnostics at the expenses of the statutory employers' liability insurance funds (UVT) if there is a possibility of a work-related skin disorder in an employee. Acceptance of this most relevant tool for secondary prevention in occupational dermatology in Germany is high and most dermatologists make careful use of this unparalleled privilege. However, there have been occasional complaints by the UVT, concerning overly extensive diagnostics. Consequently, the Task Force on Occupational and Environmental Dermatology (ABD) of the German Society of Dermatology set up a review board in May 1999. Results: Dermatologists' reports in question were submitted by the UVT to the review board and reviewed separately by two experienced occupational dermatologists both in the 1(st) period (1999-2003) and now in the second period (June 2003 - November 2009). The criticism of the reviewers was mostly directed towards the number of tests and an insufficient documentation in the dermatologist's report. There were 69 dermatologists' reports submitted to the review board (as compared to 155 in the 1(st) period). Conclusions: The decreased number of dermatologists' reports submitted could be a result of the review process itself. Other factors may include the optimization of the dermatologist's report with a better reimbursement as well as the recent publication of guidelines and continuous education in occupational dermatology with certification of more than 700 dermatologists. These measures of quality assurance are aimed to further optimize the dermatologist's procedure and to allow for improved and more rapid care for patients with occupational dermatoses by dermatologists.