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Always a tricky ethical balance this. On principle I side with Robbie's view, but pragmatically I find myself seeing entitled patients fairly regularly. I manage to rationalise it on various levels: firstly the privacy thing; it's not a big deal to queue for hours in someone else's unit, but pretty miserable to do it in your own unit, and queue jumping effectively resolves this issue. Secondly I agree with the "return them to the front line" philosophy, but that depends on what their precise job is. Finally I often do this for good old Machiavellian reasons; I figure if I do a favour for a medic or manager, then maybe they'll remember it when I need a favour in return. Works some of the time anyway! Adrian Fogarty > Sort of agree with your point re ethics of the situation. Disagree with the > illustration. This was a fairly minor disorder and would probably take about > average time to be dealt with if not less. If there were 30 patients waiting > who would each take 20 minutes of a doctor's time, the wait would be 10 > hours (and frankly, 30 patients waiting in a single doc department unless > it's minors only is unsafe). So you save 10 hours for one patient and cause > a total 10 hour wait for the others. All cancels out. Then we get down to > the debate of justice vs equity for allocation of resources. Interestingly, > if you take a strict utilitarian view, a doctor would probably need less > time taking a history and explaining than the average patient (say 15 minute > consultation against 20 minute average), so seeing them first would save > them 10 hours against a 7.5 hour combined wait for the others- your way of > doing things wastes a total of 2 and a half hours of patient time. How do > you justify that? (Equally, this is a reason for fast tracking the 'easy > minors'- or for that matter putting patients with complex problems or > communication difficulties to the back of the queue) > > Matt Dunn >