GP's problems
Sir Dr J. Rowan Wilson seems to have a chip on his shoulder about GPs. In fact the latter, by vetting patients for sick certificates and for the two-to-three months waiting list of consultants, bear a heavy responsibility. Add to this the psycho-social case load and the need to keep competent in the fields of general medicine and it is readily seen how important financially and from the diagnosis point of view it is for the doctor to bring a fresh mind to his task.
I rather agree with him about health teams, preferring myself the individual system of the Dutch doctor where private practice and compulsory insurance under a side fund is broken at salary levels of £1,500. I feel nevertheless that the great advantage of the British system of having small groups is that the patient can secure a doctor's services without the undue delay that used to occur with single-handed practices, and that the doctor can rely on a colleague highly trained in general practice to act for him whilst giving him nights free of the telephone. Where doctors operate from city centres and seek the freedom of the outskirts of an evening, a rota doctor does seem reasonable because it is in the city centres that the greatest morbidity lies and consequently the greatest freshness for the day is required. Apart from this my own feeling is that doctors should stand their nights on call. Consultants can always obtain the GP's ex-directory number by ringing the local hospital and should realise their privilege in not having to see the unvetted often frivolous calls. Both types of doctor, consultant and Gp, have these problems and advantages but I feel the GP who is firm and accurate must have a rather special value to the community and his patients.
G. Walch
Norwood, 26 Gorse Road, Blackburn
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