John
As you may know I am the reverse of this. An A&E consultant working in an
academic dept of GP. Hence I have a great interest in this.
Jeremy Dales work showed that GP principals did less investigations and
referred less with the same outcome when compared to A&E SHOs or Registrars.
So it was suggested that inner city A&Es that have high primary care
attendance rates could usefully employ a GP.
This work was prior to GP co-ops etc..
Wouldn't it now be better to have a central triage at the door and go left
for A&E and right to the GP emergency clinic. Only problem is that Jeremy
also showed that nurses not good at determining what was a primary care
problem. However neither are doctors.
I do not know of any evidence on whether it encourages primary care
attenders. I know that some list members will swear it does. But study from
Nottingham earlier this year showed that areas of social deprivation have
high primary care attendance rate at A&E. However they also had very high
rate of GP attendance.
Dr Matthew Cooke
Senior Lecturer Accident and Emergency Medicine
Emergency Medicine Research Group (EMeRG), Dept of GP, University of
Birmingham, UK.
http://medweb.bham.ac.uk/gp/
and Walsgrave Hospitals NHS Trust, Coventry, UK.
mailto:[log in to unmask]
-----Original Message-----
From: John Apps <[log in to unmask]>
To: List <[log in to unmask]>
Date: 22 September 1998 20:07
Subject: Primary Care Consultants in A&E
>I would appreciate comments from the list on these posts. Is there any
>evidence on their value? Do they encourage inappropriate use of A&E depts
>by patients with primary care problems? Do they reduce inappropriate
>referrals & investigations by junior hospital staff?
>Many thanks
>
>Dr John Apps
>BASICS North East
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