----- Original Message -----
From: "Brian Crowley" <[log in to unmask]>
To: "richard BAILEY" <[log in to unmask]>
Sent: Tuesday, March 16, 2004 12:03 AM
Subject: Re: Fw: GPSI
> Herein lies the problem - one of definition.
> Routine and complex, in my opinion, refer to the management not the
disease.
> Of course 'complex' diseases are managed by specialists - that's what
> they're there for; and for diagnosis of complex patients. But GPs see a
far
> greater quantity of 'routine' diseases and have to manage them. But it
> isn't that simple.
> Patients, as we all know, often have more than one pre-existing condition,
> and drug sensitivities/allergies, other co-existent or previous relevant
> history, ethnic factors etc which influence management decisions.
> This is where free-flowing thinking and skilled knowledge is mandatory.
> Trying to manage 'complex' patients by flow charts is, in my opinion,
> impossibly complex.
> Decision-making in such circumstances, to be safe, effective and
> appropriate, has to be undertaken by those trained is such methods.
>
> Remove medically-qualified primary care from the equation and PCTs would
be
> swamped by the deluge - used advisedly - of 'complex' chronic disease
> management foundering on a shore of poorly-staffed and -resourced
> professionals trying to cope in the face of such a catastrophe.
>
> Brian
> ----- Original Message -----
> From: "richard BAILEY" <[log in to unmask]>
> To: "Brian Crowley" <[log in to unmask]>
> Sent: Monday, March 15, 2004 8:00 PM
> Subject: Fw: Fw: GPSI
>
>
> > > >
> > > > > As far as (3) is concerned, we don't do _routine_
> > > > chronic disease
> > > > > management, we do complex CDM. I defy any one to
> > > > do that properly and
> > > > safely
> > > > > without a medical degree.
> > > > >
> > > Not according to George Alberti. If the GP's do all
> > > the complex chronic disease management I'm sure my
> > > colleagues will be thrilled. they can cancel all their
> > > follow up appointments. As I worked as a GP for
> > > several years would have to disagree on the complex
> > > bit. Not many of the chronic diseases I delt with were
> > > complex at all and thos that were you ended upo
> > > getting specialist help for.
> > >
> > > Fred.
> > >
> >
> >
>
>
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