Only 9 more weeks at the lower end of the A&E food chain Simon!
Andy Webster
Registrar in Emergency Medicine
Sir Charles Gairdner Hospital
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of McCormick Simon Dr,
Consultant, A&E
Sent: 05 May 2005 23:22
To: [log in to unmask]
Subject: Re: Multiple clerkings
Nothing wrong with 'privileges of rank' Andy
-----Original Message-----
From: Andy Webster [mailto:[log in to unmask]]
Sent: 05 May 2005 15:30
To: [log in to unmask]
Subject: Re: Multiple clerkings
In Perth we have RAT consultants. (Rapid assessment and treatment). They
will not refer onto specialties- as they and in patient specialties like
their patient to be fully assessed and worked up prior to referral.
It works though sometimes they do cherry pick the interesting cases, leaving
us middle grades to deal with the social and behavioural problems and the
old lady from the nursing home "who just isn't right!"
Andy Webster
Registrar in Emergency Medicine
Sir Charles Gairdner Hospital
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC) A &
E - SwarkHosp-TR
Sent: 05 May 2005 22:07
To: [log in to unmask]
Subject: Re: Multiple clerkings
A few questions about this:
1. If the consultant is seeing every patient as they arrive, who is looking
after the sick patients?
2. There may be concerns raised about overtriage by the consultant to the
inpatient team and reluctance to discharge. What has happened to your
admission rates?
3. What about training and job satisfaction for your juniors? It seems there
is a risk that you'll be taking out either all the "easy catches" (the NOFs
etc.) which are often satisfying or that the consultant will be the only A
and E doc to see all the complex cases during their PAT time. Are either of
these an issue? (Not implying that they are- it's a genuine yes/ no
question)
4. I seem to be reading from your posts that you're appointing A and E
consultants to what the RCP would call "acute medicine" posts. Is that
right? How's it going? How does the FFAEM acute physician tie in with A and
E? (Again, not suggesting anything wrong with that, just asking if I've got
it right)
Matt Dunn
Warwick
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