Abstract
In a study of all 4275 outpatient consultations over one month in a district general hospital it was found that the clinics in surgical specialties had the largest numbers of patients. In general surgery less than half of new patients and only one third of all patients attending the clinic were seen by a consultant. (Nine months later about a third of all new patients had still not seen a consultant in the clinic.) In the medical clinics just over a quarter of patients were seen by doctors who had less than six months' experience in their present specialty after registration. Overall, doctors had been on continuous duty for at least 24 hours before a third of consultations. Doctors in training had actually worked during the previous night before attending a quarter of the clinics.
Much of the large volume of work is performed by tired, incompletely trained doctors. It is suggested that a greater proportion of the work should be performed by fully trained staff. The workload might be reduced by modifying the pattern of the consultation.
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Selected References
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- Firth-Cozens J. Emotional distress in junior house officers. Br Med J (Clin Res Ed) 1987 Aug 29;295(6597):533–536. doi: 10.1136/bmj.295.6597.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hart A. J., Edmond P., Varman D. J. Postcards or outpatients: an alternative method of follow-up. Br Med J. 1979 May 19;1(6174):1321–1322. doi: 10.1136/bmj.1.6174.1321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirk R. M. Reducing outpatient attendances. Br Med J. 1976 Jun 19;1(6024):1521–1522. doi: 10.1136/bmj.1.6024.1521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marsh G. N. Are follow-up consultations at medical outpatient departments futile? Br Med J (Clin Res Ed) 1982 Apr 17;284(6323):1176–1177. doi: 10.1136/bmj.284.6323.1176. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCormack T. T., Collier J. A., Abel P. D., Collins C. D., Ritchie W. N. Attitudes to follow-up after uncomplicated surgery--hospital out-patients or general practitioner? Health Trends. 1984 May;16(2):46–47. [PubMed] [Google Scholar]
- Shaw C. D. The problems of out-patient visits. Health Trends. 1981 Nov;13(4):107–108. [PubMed] [Google Scholar]
- Stott N. C., Davis R. H. Clinical and administrative review in general practice. J R Coll Gen Pract. 1975 Dec;25(161):888–896. [PMC free article] [PubMed] [Google Scholar]
- Vissers J. Selecting a suitable appointment system in an outpatient setting. Med Care. 1979 Dec;17(12):1207–1220. doi: 10.1097/00005650-197912000-00004. [DOI] [PubMed] [Google Scholar]