IAN QUIGLEY wrote:
>
> Bernhard
> In England we try to limit home visits as they are an inefficient use of a
> doctor's time.
> In my surgery we have a doctor out every morning doing visits 0900 -11.30.
> Most of the patients seen are elderly and housebound.These visits are not
> usually urgent.
> Some visits are to patients who feel too ill to travel to the surgery.( or
> children whose parents refuse to bring them because they think they are too ill)
> Occasionally the patient is seriously and acutely ill.
> For the rest of the day there is a doctor on call. He or she will visit suddenly
> and seriously ill people. Anyone who sounds(over the phone) fit to travel is
> encouraged to come to the surgery.
> To answer your question more specifically visits are necessary because we are
> not in a legal position to refuse.If the patient says they can't come to us then
> we have to put ourselves in a position to make a diagnosis which means we have
> to visit. I personally would prefer not to do any except for the absolutely
> housebound.
> There are other arguments for doing visits.
> - priviledge to enter patients' homes and gain further insight etc
> - patients expect it having paid their taxes !
> - GPs ideally placed to triage their patients when acutely unwell, ie more cost
> effective for us to sort them out than for everyone to be dragged off to
> casualty in an ambulance.
> That is four reasons
> A fifth is that we are paid ( a little ) extra to see them at night between
> 22.00 and 08.00
> Some of my colleagues will probably consider me a cynic but I feel the system is
> abused by our patients
> in such a way that British GPs may eventually refuse to do home visits
> altogether.
> What do you do in Austria ?
> Ian
> http://ourworld.compuserve.com/homepages/ian_quigley
> to see what we tell our patients about home visits !
Ian,
at first, excuse my English. I'm not a nativ-speaker and learned at
school 8 years Latin, 6 Old-Greek and only 4 English.
Unfortunatly I can't work in Austria in a group like you. Therefore I do
my home vistis after my office time. In our Quality Circle we think, it
is important for a GP (in German "Hausarzt") to make home visits, even if
we are loosing a lot of time. But in our group there is a big differnece
of the frequency and therefore we want to find guidelines.
To answer your question: It's not a good way to refuse home vistits for
all patient! But of course everyone who is fit to travel (the most are!!)
should come to the surgery! My group and I think, that the "social
indication" (for example elderly and housebound people) is important.
What do you think ?
Bernhard
--
Bernhard Fuerthauer (MD), Austria
e-mail: [log in to unmask]
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