From: "Dunn Matthew (South Warwickshire General Hospitals NHS Trust)"
>Most general practice is not acute.
--> Agreed.
A significant proportion of Emergency Medicine also is not acute. A
different proportion, depending on many factors, but, nevertheless, a
significant one.
One major aspect is that General Practice is PERCEIVED not to be acute, by
patients and by other human beings, including doctors. This initial
perception modifies the way the patients interact with the doctor and the
way the doctor interacts with and interprets the clinical information he/she
comes across. In particular, there are the implications of what is not asked
and not said - these are different when you see an SHO at 3am in A&E as
compared with what you would not think to mention to a GP...
Even in today's lay media we hear of the consequences of what happens when
the basic assumption (by patient AND doctor) is that there is NO emergency.
This is why we strive to create ED systems to avoid this and educate our
junior colleagues accordingly.
I have no concern for the future of our specialty.
I have a major concern that by not making a
big/major/loud/active/uncooperative stand now against things we believe is a
"problem" we might delay the solution. In trying to extract and "save" the
bits of a monster which are not "bad", we may also help "save" the bits we
already have evidence are not good!
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