Site identification challenges in dermatologic surgery: A physician survey

Background: Previous single-institution studies have shown that patients and physicians struggle to identify biopsy sites requiring surgery on the day of treatment. To date no studies have been done to assess if this is a widespread challenge faced by many dermatologic surgeons. Objective: We sought to determine if site identification is an issue among Mohs surgeons, and to determine which practice environments have the best supplementary data available to surgeons for site localization. Methods: We conducted an online survey of 722 members of the American College of Mohs Surgery inquiring about site identification and documentation typically received from referring physicians. Results: Of 325 surveys completed (45% response rate), 71% reported that more than 5% of their patients have difficulty identifying their surgery site. The majority (89%) responded that a photograph is most useful for identifying biopsy sites. Surgeons in academic centers and multispecialty group practices were more likely to receive a photograph versus those in private practice. Limitations: Individual survey responses may be subject to recall bias. Conclusion: Difficulty identifying biopsy sites needing surgery is a common challenge faced by Mohs surgeons. The majority of Mohs surgeons surveyed find photographs the most useful documentation for decreasing the risk of wrong-site dermatologic surgery.