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In article <[log in to unmask]>, Dr Alan Hassey <[log in to unmask]> writes >TOO accessible! Much of the crap should be screened out by a triage >system, leaving >doctors to deal with the rest, doing what we (in primary care) do best - Three points: 1. Most people are very selfish when they are feeling ill or worried about their own health or survival. This (particularly) includes overtly pleasant patients, the ones who want to be friends, medical and nursing colleagues. 2. There are still exceptions. Only last week a farmer's wife requested a routine visit after morning surgery. She had fallen and fractured neck of femur at 6pm the previous evening. After 16 hours painful immobility she apologised for making a fuss. 3. A traditional view of general practice, which may be enshrined in the primary care led NHS (depending on what that means ), is that one role of the generalist (GP or primary care physician) is as gate-keeper. There seems to me to be an irony in delegating this role to another group: unless of course the triage nurses undergo 3 year VTS scheme and pass a test of 'minimal' competence at the end of it. At times of pressure our district hospital has a consultant vet all admissions by talking to the admiting GP on the phone. In my experience, they are always more polite and readier to admit than are their juniors. If that is a model of triage, the patients are bound to like it! Happy New Year. Paul Paul Robinson GP & Course Organiser Scarborough %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%