stethoscope or dermatoscope?

 

dermatoscope

When attempting to describe the utility of POCUS, the use of US has been described as the stethoscope of the future and that the stethoscope, born with René Laennec 200 years ago in 1816 was dead.

However I posit that within the Australian general practice setting, the dermatoscope is the better comparison. The dermatoscope aids in treatment by improving accuracy of diagnosis, allowing benign skin lesions to remain and confirming concerns about suspicious lesions.

  • Using the dermatoscope well is a skill that benefits the patient with less benign lesions removed through better accuracy in diagnosis
  • The clinician benefits from extension of diagnostic skills and satisfaction gained from assisting the patient
  • The dermatoscope is not required for GP clinic accreditation, unlike some other clinic equipment (a stethoscope is mandated)
  • There is no direct remuneration for acquiring the skills to use the dermatoscope and no MBS billing number for using it (there are some cases when there are Meidcare items for clinic US use)
  • The dermatoscope is at least ten times the cost of a stethoscope (US ranges from dermatoscope cost second hand to ten times again).
  • Patients appreciate you taking the extra time to use comprehensive equipment for a comprehensive examination

Where my comparison falls down:

  • Dermatoscope examines only one organ (although stethascope only really does 4 – heart, lungs, bowel, blood vessels). POCUS does them all (even brain with optic nerve diameter measurement!)
  • Dermatoscope use is not as broad in the medical family as stethascope or POCUS, only GP and dermatology.

 

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Author: gppocus

Urban general practioner in Melbourne, Australia

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