Is change in general practice good?

摘要

Like many GPs I dread the psychiatric consultation that requires an immediate specialist assessment. The referral is disputed by suggesting the patient is not in their catchment area. Once this hurdle is overcome the next obstruction arrives like a bullet as inevitably the patient is aged 17 years or less, or 60 years or more and that falls in the remit of 'the other service'. A phone call to that 'other service' says 'No, no, the service you just rang has informed you incorrectly'. Eventually, after a reluctant agreement that the patient needs to be seen, now exasperated, you are then asked, 'Can it wait until tomorrow?'.