The impact of physician specialty on quality of melanoma care.

8563 Background: This study aimed to investigate associations between physician specialty and nonadherence to National Comprehensive Cancer Network (NCCN) stage-specific treatment guidelines in a population-based cohort of elderly melanoma patients. Methods: Patients with stage I-III melanoma were identified from the SEER-Medicare database (age ≥ 65, 2004- 2005). Stage-specific multivariate analyses were performed to assess physician specialty and nonadherence to NCCN guidelines while adjusting for demographics, socioeconomic status, comorbidity, and histology. Results: A total of 3,287 patients were identified with stage IA (47%), stage IB (26%), stage II (21%), and stage III (6%) melanoma. Initial melanoma diagnosis was made by dermatologists (DERM: 56%), general surgeons (SURG: 18%), primary care physicians (PCP: 10%), plastic surgeons (PLS: 8%), surgical oncologists (SURGONC: 2%), and other specialties (6%). Definitive treatment was subsequently rendered by SURG (32%), DERM (28%), PLS (10%), SURGONC (...