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> >NHS direct, door to needle times have increased the workload. I don't have >the resources. Am I alone? Can my colleagues, Cliff and even Stephen give >me some constructive advice. What do I do? > >Danny McGeehan Essentially, as I see it, the problem has become bigger than the specialty. As I see it, A/E is dying. We cannot even all agree as to what form the specialty should take. (previous thread and others) Some time ago, I was told by my boss that the DoH wanted to do away with A/E as a specialty. He believed it. With the forthcoming national service framework, that could well be on the cards. Perhaps A/E +/- Emergency Medicine has had its day and we are now facing the same crisis that the TB physicians and chest surgeons had when TB became less prevalent (I'm too young to remember when!). Sounds depressing? Actually, its a wonderful opportunity to reinvent ourselves. Perhaps we could oversee the new service in whatever form it takes. Perhaps we could all be forcibly retrained to become inner city GP's (much needed for the govts plans). Perhaps we could all go our separate ways and rediscover ourselves in other areas of medicine. What I do know is that the service is a dismal failure. It is killing us (have had to thrombolyse one senior colleague already). So here's my constructive advice... Go and do some reports, run a sports injury clinic, ensure that you alone have sole charge of your department (colleagues are very stressful) and FIDDLE WHILE ROME BURNS!!!!!!!!!!!!!!! -- Stephen Hughes