Skin cancer screening by dermatologists, family practitioners, and internists: barriers and facilitating factors.

OBJECTIVE To determine barriers and facilitating factors to skin cancer screening practices among US primary care physicians and dermatologists. DESIGN Survey. SETTING Physicians randomly selected from the American Medical Association's Medical Marketing Services database from April 1 through November 30, 2005. PARTICIPANTS A total of 2999 US dermatologists, family practitioners, and internists. MAIN OUTCOME MEASURES Results based on 1669 surveys returned regarding practice characteristics, skin cancer screening behaviors, and barriers and facilitating factors to performing full-body skin examinations for patients. RESULTS The overall response rate was 59.2%. More dermatologists (552 [81.3%]) reported performing full-body skin examinations on patients than did family practitioners (333 [59.6%]) (P < .05) or internists (243 [56.4%]) (P < .05). Among all physicians, time constraints, competing comorbidities, and patient embarrassment were reported as the top 3 barriers to performing full-body skin examinations, and these barriers were different among medical specialties. Among all physicians, having patients at high risk for skin cancer, patient demand for complete examination/mole check, and the influence of medical training were reported as facilitating factors to performing full-body skin examinations. CONCLUSION Becoming more knowledgeable about physician barriers to skin cancer screening could help improve primary and secondary practices in both the primary care and dermatology settings.