KT wrote:
>the
better you know a patient the easier it is not to investigate?<
the better you know them the harder it can be to withstand the subtle
pressure from the patient 'to do something' (locums win out here,
potentially)
overinvestigation may be more to do with the GPs awareness of the
usefulness of the result (boring mode: prevalence, accuracy of test etc)
or maybe some GPs aren't that reflective; just want to coast thro' a
day, pleasing 'les punters' and no medico-legal threats (ie defensive
medicine): this tendency could increase with a GPs experience, burn out
etc (people spring to mind;-))
of course consultants over-investigate more than we do; stands to reason
Dunnit following up the false positives we've generated with the _really
expensive invasive sexy stuff_
owen dempsey
GP
West Yorks
UK
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Katie Law
> Sent: 11 October 1998 09:35
> To: [log in to unmask]
> Subject: Re: Excessive sweating
>
>
> 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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