In article <[log in to unmask]>, J McGuire <[log in to unmask]
net.com> writes
>I think that some of them have a compulsive desire to consult with the
>doctor at least once a month. Often for little more than social
>reasons and the presenting complaint is often almost arbitrary,
>serving only to justify the attendance.
Totally agree.
I have several in this category - not exactly dependant on me, but
certainly habituated.
When I started off as a gp I was not confident enough not to investigate
such patients. Yes, I had been taught about the use of time, had read
all about "tickets" etc. but still worried about missing something
important.
Confidence not to do things appears with time and experience.
I still have a tendency to over-investigate.
This varies on a day to day basis, sometimes even according to time of
the month etc.
Does this not take us back to the continuity of care arguments - the
better you know a patient the easier it is not to investigate?
I would also argue that it is too easy to do investigations - e.g. we do
pregnancy tests at the drop of a hat when time will provide an answer as
often as not, we send MSUs at the first sign of so called *cystitis*.
If presented with these same symptoms in the middle of the Antarctic or
somewhere equally rural (Wales?) we would have to use time and intuition
and clinical expertise alone.
--
Katie
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