Editor—I read Farrell's Soundings column, on the good slut of general medicine admitting cases other disciplines would decline, with a mixture of pride and sadness.1 I felt enormous pride in the fact that the utilitarian nature of general medicine is recognised by our beleaguered colleagues in general practice. I was also particularly impressed with the recognition of the “game” we play when justifying such [social] admissions to each other, couching the awkward in the vaguest of terms so as not to offend one another.
But I also felt sadness. Sadness that as general physicians we don't celebrate and embrace our role as the “last refuge of the lost.” It is time we ceased complaining about the unpredictable vagaries of a post-take ward round and rejoiced in our ability to deal with all the difficult conditions and situations that other hospital disciplines feel unable to cope with.
The serious point to be made is that, if some disciplines are “forced” to take patients who they would rather not, it probably follows that this may well affect the standard of care those patients receive. The passive acceptance with which general medicine takes all comers ironically means we simply get on with dealing with what we are given, quietly and with perhaps only a little complaint.
If I was optimistic I would hope that this article might herald the dawn of a new age of general medicine in which we are truly appreciated for what we are. In the absence of optimism I can at least consider that as general physicians we might be unsung heroes.
Say it loud: “I'm a slut and I'm proud.”
Competing interests: LGM is a general physician.
References
- 1.Farrell L, The good slut. BMJ 2004;329: 409. (14 August.) [Google Scholar]