Oliver Frank wrote:

> are probably intended by their funders to provide mainly secondary care,
> do also provide primary care by allowing anybody to walk in to their
> emergency departments and be seen for problems that could have been
> treated often better and usually much more cheaply in primary care
> settings such as general practice.
No,

The funders (especially the Feds) insist, by legislation, that any H. sapiens 
who
presents at an ED must be seen by a doctor, no matter how trivial Triage nurses 
can triage, but
cannot send a patient away, ever. The hospitals would love to change this rule.

Generally the numbers of ED presentations who really could be managed in 
[urban] GP is barely 10%
Usually these people never get into a cubicle and are seen quickly by the 
intern/junior resident,
so cheaper is very debatable (viz. the hourly rate of an intern in Vic is $21, 
less than a cat B consult)
they are not a big issue in EDs, in particular are not a source of overcrowding.
Most present after-hours when (in fairness to the patient) GPs are not 
available.

However, the primary care so provided is dis-continuous and generally crap: 
that's the big issue IMHO.

Ian
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