informed patient issue i would have thought - he goes to your normal place or risks the later diagnosis at the place he prefers. as long as he knows the score that's within his choice and not your problem (usual document in the notes carry on though). i would not waste too much more of your energry on the patient or the NICE guideline obsessed alternative provider.
adrian
2008/11/28 Paul Bromley
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67 year old-chap normally fit and healthy presents with 2 week history of constipation - very definite change of bowel habit. Would you refer on a 14-day wait? Bowels usually completely normal. NO co-codamol or anything like that. Soft faeces sitting in rcetum - abdominal examination normal
The reason I ask is that my usual course of action would be to refer. The centre that I normally refer to accepts just a letter and a 14-day request sheet. The place that he wishes to go to has the rigid proforma that they stick to - change of bowel habit persisting over 6 weeks. Am I wrong referring this chap as a 14 day wait as until proven otherwise I would like to exclude neoplasia. Should I be sending these patients away with a laxative and just review in 6 weeks???
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Best Wishes
Paul Bromley
www.informatiks.com
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