Don't know about Dr Cottingham, but the rate is achievable. I do from time to time go at that rate or higher myself, although in a relatively small department it is unusual to have 20 patient present at a time. It does rely on having the patients present in the cubicles when you arrive; already on a trolley if they are slow at getting on a trolley and with the appropriate body part exposed. The way to combine it with teaching is to go in with the F2, see the patient and tell them what to write while they write up the notes. Or alternatively swap roles. The two doctor idea was one I came across as an experiment in Stoke while I was a registrar- either Tony Redmond's or Mark Prescott's idea, I think. I was initially sceptical about efficiency but in fact the talking/ examining and writing take about the same length of time. What struck me was that whether I was in with a doctor of the same, higher or lower grade and whether I was the examining or writing doctor it worked as a learning experience.
Outside Emergency Medicine, things have changed but when I worked in General Practice (in the days when no evidence of being adequately qualified to do so as a locum was needed) it was not uncommon to have 3 minute appointments.
> "I could easily see 20 patients
> an hour and teach an F2 in minors in such a system."
>
>
> I challenge Dr Cottingham to do this.
>
Matt Dunn
Warwick
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