Much as I appreciate Dr Coward's efforts to explain to me what I meant, what I
actually said was:
"Most general practice is not acute. General Practice is changing as a speciality,
but
it seems that what GPs do best and what has the most impact on the health of
the
population are primary prevention, secondary prevention and chronic disease
management"
This was actually what I meant: most work in General Practice is not acute. Most
of the benefit from General Practice to health comes not from doing the simple
bits of emergency medicine but from doing the complex bits of primary care.
General Practice is a difficult speciality which is why it is easy to tell the above
average from the below average GPs. I have worked in areas that have been
lucky to have GPs with above average ability in disease prevention. I have also
worked in areas where GPs spend more of their effort on acute care and have
less time to spend on chronic care and disease prevention. Some of this may be
due to different abilities of different GPs. Some of it may be due to different
populations- some groups are less likely to attend their GP for anything other
than acute care. The efforts of GPs on disease prevention and chronic care have
a greater effect on our workload in EDs than their efforts in acute care; and a far
greater effect on the health of the population as a whole.
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