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Poor performance or prejudice?

I read with interest MPs' criticism that GPs are not able to diagnose cancer (News, November 1). I am not sure whether there was any basis for making such a statement, but it is certainly rather generalised. It seems to be irresponsible to do so.

In our area we have a policy that if a patient is suspected of having malignancy he is referred through a fast-track system and seen within two weeks in the outpatient clinic. I find it quite satisfactory and the patients have been quite happy with the system ­ there have been no complaints.

One can't expect that all the investigations could be carried out on the same day. And even if the there is a strong clinical suspicion of malignancy, one would not like to reveal the diagnosis without having it confirmed by investigations.

It is, therefore, clear that all these above procedures will take some time, for which GPs cannot be blamed. No one can deny that early diagnosis helps management but we have to be realistic in our approach and I am not sure how the blame could be put on to GPs' shoulders. Further training may help improve GPs' knowledge but it will not reduce the waiting time for the investigations any further.

I would like all my patients who are referred to outpatient clinic to be seen next day, but is it realistic? If there is more funding available it will be better to utilise it to reduce the waiting time.

Most of the GPs try to keep themselves up to date by attending the clinical meetings and through medical mailings.

I think it should be left to the individual practitioner to improve his skills if he had a special interest in any field, including cancer.

Dr SM Ali



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