Hi Mary
(Deliberately unsnipped for clarity)
>>"Peter Wilson" <[log in to unmask]> wrote:
>>>Just recently I've noticed several members
>>> requesting advice or opinions on specific problems yet there is always a
>>> danger of breaching confidentiality even if the names and other
non-critical
>>> details are changed.
>>>
>>> The lack of an appropriate informal facility is especially
disadvantageous
>>> to the single-handed GP like myself and I have two particular cases at
the
>>> moment where I would greatly value other GP's input yet the conditions
are
>>> so rare that the patients could be identified by merely their diagnoses
and
>>> the fact that they are my patients.
>>>
>>> Does anyone have any suggestions? Is there any scope for establishing a
>>> panel of GP "specialists" advertised on gp-uk with whom one could invoke
a
>>> one to one dialogue?
Graham Balin replied:
>>Not a bad idea,especially, as you say, for us single-handers. What I
>>miss most (well, actually , apart from holidays, the *only* thing I miss
>>about group practice), is the ability to say 'can you just pop in and
>>have a look at this?' or 'can I have a quick word about old so-and-so.'
>>
>>Putting one's surgery phone no. is not going to be a particularly good
>>idea as you could get 5 replies which is a waste of people's time all
>>round.
>>
>>How about asking for help on 'a patient with a rare metabolic illness'
>>say, or some such term to localise the field of expertise needed. That
>>way anyone who wishes to help can e-mail or fax you their phone number
>>and you can have a 1-1 dialogue. If 5 people e-mail you, you can pick
>>who you like,get second to fifth opinions if you feel so inclined, and no
>>time is wasted.
You replied:
>Yes, but this depends on someone with suitable expertise spending a
>considerable amount of effort on helping another GP-UKer.
>
>Thinking about the implications.
>
>Are we talking about discusing individual patients without their
>knowledge and consent?
>
>If so, why not:-
>1. get consent
>2. displace the query, so that it cannot be connected to a patient in
>*your* patch.. e.g. forwarded message.. preferably forwarded by someone
>who is *not* a clinician of any sort! ;->>
>3. both
>Mary
On reflection I think I could have worded the original posting better.
Graham mentioned rare metabolic diseases but I rather had in mind patients
with conditions which by themselves are not _that_ rare but whose management
is complicated by those factors with which GPs have to cope, e.g.
co-existing problems, localy available resources, family and social
circumstances. If a patient has Maple Syrup Urine disease then this will be
managed largely by a tertiary Specialist and there is probably little to
gain from gp-uk input for that specific problem (No offence intended guys
and gals - it was purely fictitious BTW!)
Surely we all discuss patients with other Doctors without the prior consent
of the patient and there is a vast difference between either a secure
"Doctors only" conversation (either one-to-one or via an Ahmad type group)
and open publication on gp-uk.
In the cases I had in mind the social factors would probably make informed
consent non-viable!
I'm not sure about the "forwarding" idea - isn't that traceable by looking
at the headers or do you mean a cutting and pasting job?
The time and effort involved was mentioned elsewhere but surely this would
largely fall upon the person who was seeking advice in the first place. The
replies would be largely snippets of the stated history and short SAOLs like
"Nah, you don't wanna do that!"
Overall I think the benefits of Ahmad's group outweigh the one to one idea
but if that fails to take off then I will try out those who replied
personally - metaphorically speaking to any with painted fingernails ;-))
Cold out innit?
Peter
Dr Peter Wilson <[log in to unmask]>
GP, Broadstairs <http://www.albionrd.demon.co.uk>
Medical Director - East Kent Doctors On-Call <www.ekdoc.com>
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