In message <[log in to unmask]>, Rowland Cottingham
<[log in to unmask]> writes
>In-Reply-To: <"0930075928-Re: charging inappropriate attenders"@MHS>
>> 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.
>
>That's easy! They won't clear off otherwise! I agree entirely with the
>rest of your posting, but until people feel they get an adequate service
>in Primary Care they will continue to pitch up and expect, nay demand to
>be seen.
Another interpretation would be that patients feel "they've got their
money's worth" if some hospital doc in a white coat doesn't make them
wait for an appointment in 2 weeks time, spends 30 minutes talking to
them and examining them, does 8 different blood test, and ECG and a CXR,
then gives them 2 different antibiotics and 2 different painkillers, and
all that for a sore throat that his stupid GP told him just this morning
was just a viral thing that would go away without treatment. And lo! The
sore throat did go away because of the extensive, expensive and entirely
unecessary management by the A&E SHO. Patient's will only realise that
the care they get from GPs is not just adequate but (usually) excellent,
if the hospital A&E department sings from the same hymn book.
Options:
1) employ GPs to deal with the priamry care brigade in A&E (Highly
costly, not practical in smaller departments)
2) emply Nurse practitioners to do the same (Almost as costly, and
slower)
3) Educate existing medical staff in the finer point of minor illnesses
and injuries, wwich they've not seen at Medical School or in House jobs.
(Cheaper, more flexible, ? more use to most SHOs than learning how to
put a chest drain in). Was there some talk of extending the PRHO year to
18 months, to include 6months in GP-land?
===========================================================================
Dr. Gautam Ray (e-mail: [log in to unmask])
Sussex, U.K.
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To err is human, to forgive is not management policy
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