>But there is a limit; I don't mind dealing with those aspects of primary
>care that can be vaguely defined as "emergency", in other words, I don't
>mind how trivial it is, we can sort it out as long as it's a recent
>problem. What I can't do is transform our ED into a true primary care
>centre. And this is where Joe Public remains a bit thick (excuse my callous
>disregard for the IQ of my average patient) but they seem to think that I
>can sort out all their six-month-old aches and pains "because my GP's
>useless, Doc, he never does anything, never even examines me, that's why
>I've come here, to the hospital, to get it sorted out" etc etc. Sound
>familiar? I hear that line several times every day, I swear it.
--> ... And I agree with what you have said. However, it strikes me that:
1. The "reasons" or advantages of going to ED instead of GP have been listed
(flexible timing, can be done on the way from work, requires no planning,
don't miss soaps, bla, bla & triple bla). Please note that seeing you, AF,
or me or any other consultant, IS NOT on this list.
2. Now, I would consider myself fortunate to be seen by yourself, but the
patient does not expect that. He/she does not want to miss a day's
work/shopping or something and is prepared/expecting to see a junior SHO in
a worn out cubicle. They don't seem to care.
3. If we ADDED to our current service a few GPs and some nice rooms to have
them in AND built some teamwork with the ED consultant/SpR on the shop
floor, AND electronic records, AND bring in all the primary care nurse
practitioners, AND tied this all with good communications with outpatients,
then everyone could come to "ED" (and be diverted accordingly) as they want
to. Centralising like this will reduce the number of all of these staff
actually required for the community involved or improve waits or both...
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