Adrian,

I'm afraid your comment shows you have not spent any significant time in
General Practice. 

We have the two man practice where one partner is on holiday abroad, the
other strains his back, and still the surgeries have to be done. It will be
in the winter when everybody has coughs and colds, and the Press will have
just said Ibuprofen causes breast cancer. It will be at that moment the
fourteen year old with abdominal pain will be sent home without being asked
about her lighter than normal last period to die of a ruptured ectopic.

On a home visit you stand in the rain waiting to be let in, ringing the door
bell, knowing that when you leave the patient will angrily phone the surgery
later to find out why you haven't gone and demand a visit after evening
surgery.

I think the GMC is totally unreasonable in the way it says that you must
always give the most complete and comprehensive attention to the patient in
front of you with no regard to the number of people waiting. You have a full
surgery, numerous visits all over town, and a full surgery to return to, but
if you refuse to visit, break the speed limit, or give an inadequate
consultation you are to blame. 

Never ever complain about hospital doctors having to be there 24 hours a
day, you are a team, and extra staff could always be drafted in from other
departments when things really go pear shaped. There is no such back up in
General Practice.

Getting off the hobby horse now my blood pressure has dropped...

Vic Calland




-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
Sent: 16 June 2005 23:35
To: [log in to unmask]
Subject: Re: Rape & confidentiality

You're kidding us surely... In DMG's words, you don't have the problem of 
the SHO ringing in sick on Friday afternoon and you just cannot close. 
Sorry, but GPs don't have that kind of pressure any more. When their slots 
fill up, the patients simply get diverted to A&E. That's not my cynical 
attitude playing out, that's reality in this part of the world. And it's not

GP bashing either, it's just the present system. GPs = controlled access in 
office hours. A&E = open access all hours.

AF

----- Original Message ----- 
From: "Vic" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, June 16, 2005 8:37 PM
Subject: Re: Rape & confidentiality

> Funny how the GP's think along these lines, but A&E just want to get 
> rid....
>
> Vic Calland
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Jel Coward
> Sent: 16 June 2005 17:10
> To: [log in to unmask]
> Subject: Re: Rape & confidentiality
>
>> But why is she telling your SHO these details at all?   One for the
>> psychologists among us, not me.
>>
> Very loud bells ringing.
> Protect her, protect her, protect her.
> This disclosure may well be a sign that she is in danger and she may or
> may not consciously know that - from herself, from the alleged
> assailant, from her family, from her boyfriend.
> She likely offered this information for a known or unknown reason.  Lots
> of time - gentleness - not pushing into anything that we think is the
> 'right thing'.
>
> Some follow-up provision- of some some - negotiated of course.
>
> She may need lots of offers of different things to do so that she can
> select something.
>
> Use of staff member who shares some cultural identity - but be careful.
>
> Hard to to make the time to do these things - but is probably the most
> important thing you will do that day.
>
> Huge opportunity for SHO to learn how to 'save lives' here - don't let
> that slip by either.
>
> Just my thoughts
> Jel