Acute medicine – an alternative take (1)

Editor – As a GP who is also interested in the interface between primary and secondary care, I enjoyed Michael Houghton's recent article (Clin Med Feb 2011 pp 26–7). I would encourage him to develop the role he is exploring as a GP in an acute setting. Houghton explores the difference in philosophy between general practice and hospital medicine. I would like to commend Marinker's¹ exposition in this respect which other readers might also finding interesting. Markiner wrote ‘the role of a GP is to tolerate uncertainty, explore probability and marginalise danger; while the role of the hospital specialist is to reduce uncertainty, explore possibility and marginalise error.’ I believe this might be helpful in understanding the different approaches to the use of investigations, and clinical risk management between GPs and consultants.