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How does it work doing a house call on your bike?

Dr John Green wrote about cycling to work (May 19). I am a GP registrar and I have always cycled to my hospital jobs, but since starting my GP year I have had to drive as I have to do house calls. Could Dr Green tell us how he goes about house calls on his bike ­ specifically how he carries all the gear?

Dr Matthew MacGabhann

Bloxburn

West Lothian

Dr Green replies:

Carrying stuff isn't really a problem. I carry a thermometer, oroscope, sphygmo, pair of gloves, KY jelly, an MSU bottle and a swab, FP10s, BNF, headed notepaper, envelopes and a couple of path forms. Notes are a computer printout on a couple of sides of A4, though of course this would be different in a non-computerised practice.

In addition you need your pump, spare inner tube or repair kit, and a couple of tyre levers. All that will easily fit into a Karrimor pannier, or even just an old rucksack.

I don't carry drugs or blood bottles unless it's likely I'll need them; even so they don't add too much bulk, and I have them ready in another bag I pop in the pannier.

Experience has shown I hardly ever give drugs now, so I'm afraid I ruthlessly prune recommendations for the doctors' black bag in the Drugs and Therapeutics Bulletin. Even so they quickly go out of date. Research has shown that 10 puffs with an inhaler and a spacer can be as effective as a nebuliser, so that's what I carry, again only when I think I'll need it.

More problematic is cycling when on-call. I didn't use to do this when I started, but now I do. In a real emergency the patient would probably be better off dialing 999, which I would advise them to do.

If they just want me there quickly for some other reason, then a bike will have to do.

There are occasions in a town centre practice like ours when a bike will be quicker anyway. But we do have patients who live well outside the town.

I reason that if called to see someone I couldn't get to reasonably quickly by bike I could cycle home and get my car (I live about 15 minutes away). Of course everyone's practice and circumstances are different, and you and your colleagues have to be happy that your patients are getting the best care.

In many if not most practices though it should be possible to cycle at least some of the time.

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