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  1. #21
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    hum..

    hold on.

    GPs do NOT make accurate diagnosis about "every patient they see". This is impossible due to the nature of the GP practice (equipment etc) and the rather "limited" knowledge a GP has in comparison to consultants.

    Having established that, consider this "why does a GP refer a patient to see a hospital consultant"? surely with an accurate diagnosis (or if a GP knew it ALL) wouldnt need to do this, right?

    A GP's job is to filter patients, treat those that can be treated in "primary care" and refer "complex" cases onto the hospital "consultants". Do remember that a consultant has much MORE training than a GP - who does a few rotations here & there for 2 years, does MRCGP and becomes a GP with a bit of luck!

    Where as, the point where most GPs finish (training wise and enter a job) hospital consultants go on training at SpR level that goes on and on for 5-6 years. A GP in comparison, therefore, does NOT have the knowledge to make accurate diagnosis ALL the time.

    If you have ever been in a hospital under work experience, you may have noticed registrars and consultants take the piss out of a patient's GP with the so-called "SUGGESTED DIAGNOSIS" - where a gp basically suggests something for doctors in hospital. It often turns out (in hospital circles) that the GPs know relatively little about "in-depth" medicine - which is required to carry out hospital-level consultations/operations.


    Correct me if im wrong..

  2. #22
    Junior Member analyse's Avatar
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    Alright, no need to be so ar$ey about it Bond geezer! Was just something my tutor had said to me... The hospitals I've worked at are more respectful of their colleagues and have never taken the pi$$ out of someone's GP, in fact they have generally made comments that they wouldn't have a clue, they only do the bit they do and wouldn't have the knowlede for anything else.
    Matt

    Foundation Medicine, St George's (Kingston Uni 1st Yr) - Offer
    BSc Biomedical Sciences, UCL - Offer

  3. #23
    Senior Member kiya's Avatar
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    Quote Originally Posted by nas007bond
    hold on.

    GPs do NOT make accurate diagnosis about "every patient they see". This is impossible due to the nature of the GP practice (equipment etc) and the rather "limited" knowledge a GP has in comparison to consultants.

    Having established that, consider this "why does a GP refer a patient to see a hospital consultant"? surely with an accurate diagnosis (or if a GP knew it ALL) wouldnt need to do this, right?

    A GP's job is to filter patients, treat those that can be treated in "primary care" and refer "complex" cases onto the hospital "consultants". Do remember that a consultant has much MORE training than a GP - who does a few rotations here & there for 2 years, does MRCGP and becomes a GP with a bit of luck!

    Where as, the point where most GPs finish (training wise and enter a job) hospital consultants go on training at SpR level that goes on and on for 5-6 years. A GP in comparison, therefore, does NOT have the knowledge to make accurate diagnosis ALL the time.

    If you have ever been in a hospital under work experience, you may have noticed registrars and consultants take the piss out of a patient's GP with the so-called "SUGGESTED DIAGNOSIS" - where a gp basically suggests something for doctors in hospital. It often turns out (in hospital circles) that the GPs know relatively little about "in-depth" medicine - which is required to carry out hospital-level consultations/operations.


    Correct me if im wrong..
    At the risk of sounding equally, uh, how can I put it...? In my local PCT, we have consultants regularly discharging patients back to the GP before anything is done. Minor Injury Units and A&E departments also send patients back to their GPs. Diabetes care has now been placed onto the GPs' workload. Pathology labs are discarding blood tests whenever they feel like it, even when specifically requested by the GP. And as for dermatology consultants, I haven't a clue what they've been doing for the past year, but they certainly haven't been seeing anyone with seborrhoeic warts or benign lesions.

    Even my personal experience of a hospital consultant is that, yes, while he/she may have an "in depth" knowledge of their particular area of expertise, they appear to have become blinkered to all the general medical knowledge they learnt in the past. One consultant even told me that Raynauld's syndrome is more common in men than women, when it most definitely is not. He was completely floudering when the test results came back and he didn't understand them. It was laughable.

    Don't ever underestimate the importance of primary care and primary care physicians. They have a broad general medical knowledge, often with in-depth knowledge in a particular speciality. Sometimes they even spot what a consultant with supposed "in depth knowledge" has failed to see.

    To be honest, I think the piss-taking works both ways. Here in primary care, we don't have a lot of good to say about the hospitals!

  4. #24
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    Quote Originally Posted by nas007bond
    hold on.

    GPs do NOT make accurate diagnosis about "every patient they see". This is impossible due to the nature of the GP practice (equipment etc) and the rather "limited" knowledge a GP has in comparison to consultants.

    Having established that, consider this "why does a GP refer a patient to see a hospital consultant"? surely with an accurate diagnosis (or if a GP knew it ALL) wouldnt need to do this, right?

    A GP's job is to filter patients, treat those that can be treated in "primary care" and refer "complex" cases onto the hospital "consultants". Do remember that a consultant has much MORE training than a GP - who does a few rotations here & there for 2 years, does MRCGP and becomes a GP with a bit of luck!

    Where as, the point where most GPs finish (training wise and enter a job) hospital consultants go on training at SpR level that goes on and on for 5-6 years. A GP in comparison, therefore, does NOT have the knowledge to make accurate diagnosis ALL the time.

    If you have ever been in a hospital under work experience, you may have noticed registrars and consultants take the piss out of a patient's GP with the so-called "SUGGESTED DIAGNOSIS" - where a gp basically suggests something for doctors in hospital. It often turns out (in hospital circles) that the GPs know relatively little about "in-depth" medicine - which is required to carry out hospital-level consultations/operations.


    Correct me if im wrong..

    Consultants in most specialities (with a few exceptions) are not General Physicians. GP's are specialists in common medical complaints and family medicine. A neurologist would have great difficulty being a GP and would probably not remember enough General Medicine to be very good. 90% of all medical problems are dealt with by the GP and only 10% of all patients who see their GP are referred for specialist treatment, therefore the clear majority of patients can be treated by their GP alone. Many GP's are specialists who have decided to train in General Practice after working in hospital Medicine for many years.

    I know that many hospital Consultants are sometimes quite supercilious about GP's - it's rather unfortunate but shows their lack of awareness about the great (and very difficult) job that GP's actually do.
    Last edited by Asclepios; 19-11-2006 at 04:22 PM.

  5. #25
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    Strange, I live in Australia, and a local GP I did work experience with told me he earned $300,000 a year.

    Although it probably has something to do with the amount of patients he has, etc.

  6. #26
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    GP training (currently):

    Foundation training: 2 years
    GP VTS: 3 years - (2500 training jobs this year)
    Need to Pass MRCGP before completion (pass rate 75%)

    Medical consultant training (Currently):

    Foundation training: 2 years
    Core medical training (CMT): 2 years - (1300 training jobs this year)
    Research (optional - but encouraged): 1-2 years
    Future specialist training: 5 years (High competition rates for popular specialties)
    Need to pass MRCP (pass rate 33%)
    Need to pass "specialist exit exam" on completion of training

    Based on those facts who would you rather looked after your mother/father when they become ill??
    Last edited by gangzoom; 16-11-2007 at 10:07 AM.

  7. #27
    Senior Member Chang's Avatar
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    exactly, hospital specialists are just that - specialist. and the more specialised they get the more their knowledge is narrowed to that particular field. so to say "who would you rather looked after you - a GP or specialist", well it is a rediculous question. if i had just had an MI i would rather be looked after by a GP than a consultant dermatologist/othopaedic surgen/nephrologist. without a GP how would you know who to approach for care? how would the lay person know that their bladder problems are actually due to spinal injury and not the bladder itself? to compare the two jobs in terms of worth and skill is impossible, indeed to group "consultants" in one bag when asking that question is also rather pointless.
    "The art of medicine consists in amusing the patient while nature cures the disease."
    Voltaire (1694 - 1778)

    University of Liverpool 5th year medic

  8. #28
    Senior Member Dr Noodle's Avatar
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    This is completely off point but, do GPs have to retire at 65? I was talking to a patient once who told me that his GP is 90 and sometimes forgets who he is, but that she's still 'very good'...

  9. #29
    Senior Member Dr Noodle's Avatar
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    I think we're a little behind in some things....I think the reason for retirement from any profession should be based on decreasing ability rather than age.

  10. #30
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    In America (a country which strives for excellence rather than competence) people work until they can work no longer.

    DeBakey (the man of DeBakey forceps) - the man who did the first carotid endartectomy - is still practicing today at the age of 99!! Ponseti worked into his 90's, Im not sure if he is still working. And the list goes on.
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    Gizmo says -

    "Lowering entry requirements therefore runs the short term risk of increased numbers of students dropping out of medical school, or the longer term risk of less well qualified medical entrants becoming less competent doctors."
    Prof McManus - Prof of Medical Education

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