Conflict of interest
AB is employed by an acute trust.
Footnotes
Please submit letters for the Editor's consideration within three weeks of receipt of the Journal. Letters should ideally be limited to 350 words, and sent by email to: Clinicalmedicine{at}rcplondon.ac.uk
- © 2010 Royal College of Physicians
References
- Stoate HGA
- British Society for Rheumatology
- Harold Gillies: surgical pioneer. Trauma 2006; 8:143–56.doi:10.1177/1460408606072329
- Royal College of Physicians. Teams without walls. The value of medical innovation and leadership. London: RCP, 2008.
Conflict of interest
I agree with Dr Cohen that general practitioners (GPs) with a special interest have an important role. It is essential that they feel part of the specialist service and participate in audit, continuing professional development and so on with specialist colleagues. They also need to be able to discuss patients easily with consultants and to access more specialist opinion when needed, as well as bringing their expertise as to how patients can be managed in the community.
Dr Cohen also makes the point that the challenge is not to deliver more of the same just in a different location – which very well answers Dr Bamji's concerns. Moving expertise into the community, working more closely with GP colleagues, community nurses and other professionals to deliver consultant input in a different way is not just an argument about geography. There are undoubtedly logistical difficulties in providing services in different places, but these can be overcome (and many consultants already deliver outpatient services in locations away from their home base). The point of consultants working in community settings is to develop better pathways of care which are more joined up across the old primary–secondary care boundaries and to truly build Teams without Walls.
Footnotes
Please submit letters for the Editor's consideration within three weeks of receipt of the Journal. Letters should ideally be limited to 350 words, and sent by email to: Clinicalmedicine{at}rcplondon.ac.uk
- © 2010 Royal College of Physicians
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