Prevention of hospital-acquired thrombosis

Perhaps the BJGP should have a moratorium on papers which state that, ‘GPs are ideally placed to …’? Yes, I’m sure you can find someone to say we’re great at everything in medicine and beyond. But that doesn’t mean it’s our job or that we are actually the best people for it.

I’m pleased to report that in our area there is no uncertainty on this issue: hospital staff, who are actually ideally placed to assess and treat hospital-acquired thrombosis, do it.¹ Surprisingly, it has never crossed my mind that we may want to take this work off them, as they have detailed knowledge of the surgery or other factors that have occurred during admission, rather than the brief highlights on a discharge letter, and they have pre-surgical assessment clinics for elective admissions already in place where this can be addressed without any need for GPs to take on yet more workload. I imagine that they also have detailed knowledge of the guidelines, as they use them every day. Sure, I’ll highlight any particular risks if I refer someone, but given that I may not see them again from referral for an outpatient consultation (at which point surgery is not definite in most cases) until they come out of hospital months later at the end of an 18-week routine wait, I’m not sure that discussion of DVT risk for an op that may not happen at that point is necessary.