# Medical Photography in Dermatology: Quality and Safety in the Referral Process to Secondary Healthcare

## TL;DR

This study finds that general doctors and dermatologists disagree on the quality of photos used in dermatology referrals, highlighting a need for better guidelines and training.

## Contribution

The study identifies a significant perception gap in photo quality and information sufficiency between general and dermatology specialists in referrals.

## Key findings

- General practitioners rated 36.2% of their photos as high-quality, while dermatologists rated none as high-quality.
- Only 76.9% of respondents agreed that photo quality is important for diagnosis and treatment.
- No dermatologists reported always receiving sufficient clinical information with referral photos.

## Abstract

Background: Medical photography is widely used in dermatology referrals to secondary healthcare, yet concerns exist regarding image quality and data security. This study aimed to evaluate the quality of clinical photographs used in dermatology referrals, to identify discrepancies between specialties’ perceptions, and to determine the general awareness of proper storage and security of clinical photographs. Methods: A 43-question survey, based on previously validated questionnaires, was administered to general and family medicine (GFM) doctors and to dermatologists at an academic referral hospital in Porto, Portugal. The survey assessed demographics, photo-taking habits, perceived photo quality, adequacy of clinical information, and opinions on the role of photography in the referral process. Quantitative statistical methods were used to analyze questionnaire responses. Results: A total of 65 physicians participated (18 dermatologists and 47 GFM doctors). Significant differences were observed between the two groups. While 36.2% of GFMs rated their submitted photos as high- or very-high-quality, none of the dermatologists rated the received photos as high-quality, with 83.3% rating them as average (p = 0.012). Regarding clinical information, 46.8% of GFMs reported consistently sending enough information, while no dermatologists reported always receiving sufficient information (p < 0.001). Most respondents (76.9%) agreed that the quality of photographs is important in diagnosis and treatment. Conclusions: The findings reveal a discrepancy between GFM doctors’ and dermatologists’ perceptions of photograph quality and information sufficiency in dermatology referrals. Standardized guidelines and educational interventions are necessary to improve the quality and consistency of clinical photographs, thereby enhancing communication between healthcare providers and ensuring patient data privacy and security.