I certainly lament their loss. I suppose over 80 the role is admirably
filled by the geriatrician. (Are we still allowed to use that term, or
is it, horror of horrors, "ageist"??)
Failing that, I go with the main presenting symptom and work with
that, check the baseline bloods and anything else I think might be
relevant.
Locally we have an endocrinologist and a cardiovascular physician who
are prepared to fulfill the role. (Scumton)
JG
2009/9/9 Julian Bradley <[log in to unmask]>:
> At 11:49 09/09/2009, you wrote:
>>
>> Yes, we used to have a haematologist, whose skills in these issues were
>> amazing. Now, for these patient I too use a 'general physician/ renal
>> physician we have talked about the issue, he reported enjoying the
>> challenge
>> of being taken to a wider world at times. It is what most concerns me
>> about
>> the new model of medical training, the model according to Osler allowed
>> for
>> most everyone to do a job which in the end was not within the core of
>> their
>> final post. It did mean that in a small no of doc's you probably had a
>> very
>> wide general experience. This will go, no one is looking for the
>> consequences and that is most concerning.
>> Alistair
>
> Agree with all, and particularly that those with the "heart" of a general
> physician may still be found in various specialities and in general
> practice, probably more to do with the individual, and the availability of
> time, than with the speciality.
>
> That said, d in law informs me there is a new speciality emerging - acute
> general medicine, where the principal task in managing the patient in the
> first 72 hours after emergency admission.
>
> Perhaps some of these doctors will also take an interest in the long term
> complex patients (so that they don't keep coming back on acute takes with
> undiagnosable multiple symptoms)?
>
> Julian
>
--
Dr John Glasspool
Barge House,
Timsbury,
Romsey,
Hampshire
SO51 0NG
UK
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