There are an incredible number of GPs who cannot even take a blood pressure, judging by my experience. I would suggest that 90% of medical personnel do not know even the very basics of taking a blood pressure.
I hope it will not be too long before the process is automated taking the subjectivity out of the measurement of this. Quoting Alexander Bennett <[EMAIL PROTECTED]>: > > > On 16/04/2006, at 12:01 PM, Ian Haywood wrote: > > > > > > > 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% > > > Having worked substantially in both Emergency and General Practice in > recent years, I would say that the figure of 10% of patients > presenting to Emergency Departments being able to be managed in > General Practice is very low and incorrect. It may reflect a view of > Emergency Medical staff that general practitioners are incapable of > more than taking a blood pressure and writing repeat prescriptions > for medication prescribed by specialists but that is in fact not the > case. General practitioners would generally be able to manage all the > category 4 and 5 patients more efficiently and more cheaply if only > they were properly resourced to do it. I would say the figure is more > like 30-50% of patients presenting to emergency departments could be > managed more effectively in general practice but recognition of this > would have some negative impact on the funding applications by > emergency departments; this would be an unfortunate circumstance as > emergency departments are also under-resourced for the job they are > being asked to do. > > In rural practice of course, it is often the same doctor seeing the > patient in the local emergency department and in a reasonably > equipped surgery where the delivery of care to category 4 and 5 > patients would be essentially identical. > > > > > Usually these people never get into a cubicle and are seen quickly > > by the intern/junior resident, > > My experience of working and teaching in emergency departments is > that one of the striking differences between junior and senior > doctors is the speed with which they assess and manage patients. I > have seen junior doctors tied up for hours with category 4 and 5 > patients. > > > so cheaper is very debatable (viz. the hourly rate of an intern in > > Vic is $21, less than a cat B consult) > > plus the triage nurse, the nurse aid, the clerk etc - overheads in > the emergency department which quickly inflate the cost compared to > barebones general practice. > > > they are not a big issue in EDs, in particular are not a source of > > overcrowding. > > Patients presenting to a nearby emergency department with urgent > problems such as earache in a child who have to wait 5-8 hours to be > seen would not necessarily agree that such patients are not a source > of overcrowding. > > > Most present after-hours when (in fairness to the patient) GPs are > > not available, > > because there is no funding for GP after-hours clinics. > > > > However, the primary care so provided is dis-continuous and > > generally crap: that's the big issue IMHO. > > Occasionally the care is excellent with good referral back to general > practice but that is the exception unfortunately. > > Alex > > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > ---------------------------------------------------------------- This message was sent using IMP, the Internet Messaging Program. _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
