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At the heart of general practice since 1960

Surgery visits turn us all into circus animals

Is Dr Quilliam pulling our legs by suggesting he would consider referring 100 patients to the chest clinic (News, October 25)? Why on earth should the PCT replace a nurse trained in spirometry? The practice claims to be left unable to carry out testing. How? Are there not any doctors in the house?

This sort of problem arises when surgeries delegate simple tasks and divide normal clinical practice into multiple clinics. These surgeries, usually large ones, find themselves stranded when their specialist professional is on leave, ill, or has been taken away by the blessed PCT.

It must drive patients mad having to come up to multiple clinics, and pity the poor patients who have more than one disease.

Does not Dr Quilliam feel any shame in suggesting that his poor old bronchitic patients crawl up to the hospital this winter in order that he can claim a few miserable QMAS points? It's cruel and unprofessional to contemplate it. Surely COAD patients are seen by a doctor at least twice a year and perhaps a third visit to the practice for the flu jab. Medicine reviews must be de rigeur for any practice, so what on earth were the doctors doing when they saw the patients?

It makes for some conversation, and only takes a moment: You don't smoke do you? Blow into this. The next time you see them, check their inhaler technique.

Perhaps this miserable practice that will consider anything, other than doing the work themselves, is also too mean to put spirometers in the doctors' consulting rooms. Perhaps their one spirometer left with the nurse.

Dr Gerard Bulger

Bovingdon

Herts

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