Skin cancer patients are managed collaboratively between General Practitioners (GPs), Dermatologists, Surgeons, and both Radiation and Medical Oncologists. With this breadth of practice, the medicolegal responsibilities associated with skin cancer management can pose a challenge to the clinician. Per 2021 data from Avant, most regulatory complaints against Dermatologists related to diagnosis, and of these 53% involved malignant neoplasms of the skin. Here we discuss the practicalities of responsible referrals as a cornerstone of skin cancer management through the lens of medicolegal liability.
There are no guidelines or standardised proformas for referrals of skin cancer patients, leading to discrepancies in the transfer of patients’ care. This is compounded by a paucity of explicit training of this process – from medical school to the specialty colleges. Ideally, a referral contains information sufficient to accurately identify any suspect lesion(s). Unfortunately, this often does not occur even with widespread ability to take and share high quality images. Where possible, the patient should be involved by asking that they can identify the lesion independently and retain their own images if necessary. Ultimately, the treating doctor must refrain from performing procedures if they have not satisfactorily identified the corresponding lesion.
Finally, we suggest techniques to improve the quality of skin cancer referrals and encourage specialty colleges to adopt formal and standardised training. We would hope this could reduce medicolegal risk surrounding delayed or incorrect diagnosis of skin cancer.