--- Paul Bailey <[log in to unmask]> wrote:
> Fred, the question I would be asking when you say:
>
> 'Depends what you mean. If you mean specialist
> delivered then there is no way the NHS could afford
> it
> at present even if we could find the docs to do it
> and
> I can't see any government stumping up the cash to
> do
> it in the foreseeable future.'
>
> is can you afford not to.
We are talking different things here. I was talking
about a consultant DELIVERED service as they have in
the US where every patient is seen by an Attending
Physician in emergency medicine. As an example I was
at a hospital with roughly the same annual attendance
as ours and they had 30 Attendings in the ED. There
were 3-4 on 24/7. Each earning $120 - 250,000. Now
there is no way the NHS or I would have thought the
Australin health service would be able to afford that!
>
> Where is your data to support no difference in
> consultant vs non consultant
> led departments. As proof from the Australian
> experience, I would offer the
> following papers:
>
I'm not disputing the benefit of consultant input just
said there was no evidence of benefit for resus.
Either in our data, that from Plymouth or the UK
cardiac arrest outcome study. Do you have any data to
suggest that survival to discharge is improved by
consultant lead resus? If you read my previous post
you would have seen that I can prove which areas my
performance is better than the SHO's.
The SHO lead service in the UK is rapidly
disappearing. We have 12/7 cover with on the floor
working. Bids are in for more senior staff and we will
extend the cover accordingly when they arrive. Some of
my fixed sessions are evenings and weekends which
gives me time off during the week! Which is nice!
Cheers Fred.
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