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Remember the 'rule of three'

Continuity of care is a question of asking: 'Is this person sicker than the last time I saw them and, if yes, by how much and over how long?'

It allows a more accurate prognostication on those occasions where a diagnosis has not been made.

Those unfortunate individuals in the news might be alive if the multiple consults involved the same doctor on more than one occasion.

Large providers would do well to remember the old 'rule of three' my GP trainer taught me, which states: 'Three consults in 48 hours without a diagnosis means admit for a second opinion, because you are missing something no matter how clever you are.'

Thanks, Peter - it has kept me out of trouble many times.

Dr Andrew Mimnagh, Chair, Sefton LMC

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