Posted on 03/17/2002 4:41:54 AM PST by CrossCheck
PATIENTS will be allowed to bypass their GP and refer themselves for hospital treatment as part of a radical patient "DIY diagnosis" plan being considered by the Scottish Executive.
The fast-track scheme would enable patients who have used the internet or medical books to diagnose their illnesses to see a consultant without the need for an appointment at their local surgery.
The plan, proposed by a senior Glasgow consultant, has won the backing of the British Medical Association and the Royal College of Physicians of Glasgow and is being investigated by the Scottish Executive.
John Sinclair, a urologist at the Southern General Hospital in Glasgow, said abolishing GPs’ traditional role as ‘gatekeepers’ to the NHS would reduce pressures on family doctors and cut hospital waiting lists.
He said patients now have such ready access to detailed medical information that many can accurately determine what is wrong with them and choose which specialist they should see.
Sinclair, 60, who has been a consultant for almost 30 years, said: "I know this is a very radical proposal and would require a great deal of consultation with GPs, hospital staff and patient groups. But we need to start making radical and innovative changes to the health service if it is to survive."
To prevent consultants being overrun with hypochondriacs, Sinclair proposes the creation of ‘diagnostic units’ staffed by specialist nurses or appropriately trained GPs who would carry out an initial assessment - a job normally carried out by specialists.
‘We need to make radical and changes if the health service is to survive’
In some cases, a referral might not be necessary. The units would relieve pressure on specialists, giving them more time to perform surgery or other frontline procedures and hence reducing waiting lists.
Sinclair said: "The idea is to have mobile diagnostic units instead of fixed clinics, thereby extending the service over a wider area and meeting demand where and when it arises.
He added: " Non-urgent patients are waiting an average of six months to see specialists after being referred by their GP. I am seeing twice the recommended number of patients each week.
" There will be some inappropriate self-referrals , but I am convinced the advantages would far outweigh the disadvantages."
Sinclair claimed that strict professional auditing of the service would ensure that the standard of diagnoses was maintained.
David Smith, vice-president (surgery) of the Royal College of Surgeons and Physicians of Glasgow, said: "In principle we believe there is a lot of merit in this scheme. So long as it did not put further pressure on staffing levels within the NHS and the diagnostic units were manned by new specialist staff, this could do a great deal to fast-track the system to the benefit of staff and patients."
A spokeswoman for the BMA Scotland said the proposal had much to commend it, but warned: " While some services may adapt easily to this type of environment, others require to be provided in a clinical setting."
A spokeswoman for the Scottish Executive said the scheme would be considered as part of the process to improve patient care. "While not all suggestions prove workable, we welcome ideas on ways to further improve access to health services."
First, I had to see the primary care physician, who referred me to an ortho doc, who took x-rays and then referred me to the neurosurgeon. There was a lot of money and time wasted to get me to the doctor I needed to see.
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