Patient choice of primary care practitioner for orofacial symptoms.

OBJECTIVE: To determine patients' preferences regarding consultation of medical or dental practitioners for various orofacial symptoms, including patients' perceptions of practitioners' training and ability to diagnose and treat these symptoms. METHOD: Patients attending oral and maxillofacial clinics in Dumfries & Galloway, Scotland in relation to a variety of complaints were invited to complete a questionnaire. RESULTS: From a sample size of 254 patients, 220 correctly completed questionnaires were received. This showed 69% of patients regarded medical practitioners as being better trained to diagnose and treat non-dental orofacial symptoms. Eighty percent of patients regarded medical practitioners as being more accessible when booking an appointment. Seventy-eight percent of patients did not regard charges for dental care as being an important factor when deciding which practitioner they should consult. CONCLUSION: Despite the significant differences between medical and dental practitioners in undergraduate and postgraduate training in orofacial disease, most patients would choose to visit a medical rather than dental practitioner. While these results suggest the need for postgraduate educational support for medical practitioners in treating orofacial pain and oral mucosal disease, they also imply a need for change in the concept of provision of oral healthcare by general dental practitioners.

Characteristics of patients attending rapid access clinics during the West of Scotland Cancer Awareness Programme oral cancer campaign.

AIM: In 2003, the West of Scotland Cancer Awareness Programme (WoSCAP) launched their oral cancer campaign to raise public awareness of the disease in five NHS boards across the West of Scotland. The aim of this study was to evaluate the campaign by reviewing patients attending rapid access clinics in the 11 secondary care units across the five boards. DESIGN: Data were collected in 2004 during the second phase of the campaign via a two part self-completing questionnaire; the first part collected information from the patients and the second part from the clinicians, in rapid access clinics in the secondary care units. RESULTS: In total, 580 questionnaires were given out in the clinics with 538 completed patient sections (response rate 93%) and 500 completed clinician sections (response rate of 86%). More than two thirds of rapid access secondary care patients had seen a recent health campaign related to mouth cancer, and 46% responded that the campaign had encouraged them to seek advice more quickly. Of the patients examined in the clinics, 5% had a provisional diagnosis of a malignant lesion, 7% a potentially malignant lesion, and the majority of lesions were benign. The clinicians deemed 30% of the referrals to be inappropriate. CONCLUSIONS: The results show a high percentage of patients attending rapid access clinics were aware of the campaign. However, there were a disproportionate number of inappropriate referrals to the rapid access clinics compared to genuinely urgent cases.