I really don't understand why (in the UK anyway) A&E docs will still see and
treat primary care appropriate patients (or "inappropriate attenders) after the
punishment of a several hour wait. The Specialist who provides the best and
most up to date advise / treatment for these people is the GP who is a
specialist in his own right (despite what people might think). We wouldn't be
providing definitive (eg) ENT, psychiatric etc etc advise for non-Emergency (as
opposed to urgency!) conditions so why should we be smug enough to think we
could do the GP's job. We'd certainly rubbish the GP who tried and failed to do
the A&E doc's job - because don't they realise we're a speciality too??!! - if
we are a speciality we should stick to what we specialise in. Anyway take the 3
month headache for example - if you try and get any more involved in this
further than referring back to GP and miss the space occupying lesion you're the
one responsible for the consequences - and too right for stepping out of your
role - the same applies to less emotive things - if the rash you've tried to
treat doesn't get better you've now inherited that problem, shame if the GP
could have sorted it at the first consult!
If you're a specialist in A&E stick to A&E work and let the generalist
specialist GP do his without interference.
Nick Jenkins
A&E Consultant, Abergavenny
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