How to improve sun protection counseling in a primary care setting

Document Type

Conference Proceeding

Publication Date


Publication Title

J Am Acad Dermatol


Skin cancer is a significant public health concern in the United States as there continues to be an increasing number of cancers annually. Ultraviolet exposure is linked to the risk of developing skin cancer, but only a little more than half of the American practice sun protection. While many studies have shown that counseling can increase patient knowledge about sun protection, the counseling rate by physicians can be very low, especially in a primary care setting. Given that majority of the patients in this nation will likely see a primary care doctor before a dermatologist, we sought to see the rate at which a primary care physician provides counseling about sun protection. A survey was sent to primary care doctors and dermatologists in the Detroit and Ann Arbor area. Survey results showed that primary care doctors counsel significantly less than dermatologists. Also, primary care doctors are less likely to perform a full skin exam or use sunscreen themselves. Based on the results of the study, we were able to identify the barriers to primary care doctors performing counseling. We followed up our survey by providing educational intervention to the participating internal medicine doctors in the form of a lecture and an informative email. These doctors took the survey again after the intervention. Post-intervention survey results showed that doctors who participated in the intervention were more likely to wear sunscreen during the winter and were more accurate in counseling their patients on reapplication of sunscreen. Although statistically insignificant, post-intervention doctors trended towards being more comfortable providing information on sun protection and higher frequency of counseling their patients on sun exposure, sun protection, and tanning bed use. Based on our study results we conclude that primary care physicians need to be educated on how to provide better sun-protection counseling. Interventions such as lectures and emails may be helpful, but future studies with higher power are needed to further investigate these interventions.




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