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Matt, I thought this was a joke....I realise to my horror it is serious. You only need a clinic if you havent got enough experienced doctors 24/7. Thats why many UK EDs have em and Australian ones dont. It is a safety net to protect against the pitfalls of inadequate senior staffing. There is no other justification. To take your points one by one > > Advantages of clinics: > 1. Follow up allows us to check what is happening- > kind of informal audit. 1.Rubbish. You will see what the juniors send to it and no more, nor will you see those they dont want you to know about!! > 2. Trickier patients all get seen by a consultant 2. The trickier ones are mostly in the major end. Having a clinic is justified if you havent enough seniors but you cant call it an 'advantage of having a clinic'. > 3. A lot of minors cannot be fully assessed at > initial presentation (for > example differentiation of depth of burn; > differentiation between ankle > sprain, partial rupture of peroneus tendons or > tendon subluxation) better off going to a physio (that includes knees andy lockey) so they get treated as well as observed. Best option - employ your own. A valid use of reforming emergency care monies if youve any left. > 4. Allows development of special interest. Sounds like skewing the departments workload, resources and nurse time towards an area of interest rather than where it is most needed. ED Hand clinics are a good example. > 5. Takes on the cases that nobody else wants to > follow up. Thats just silly > 6. Helps development of medicolegal practice. Indefensible. Is that in your business plan for consultant expansion as well? > Overall, clinics don't take up much in the way of > resources and provide a > good service. I remember them rather differently. Steve Meek > Matt Dunn > Warwick > > __________________________________________________ Do you Yahoo!? Yahoo! Mail Plus - Powerful. Affordable. Sign up now. http://mailplus.yahoo.com