BMJ 1996;312:575 (2 March)

Letters

Referral pattern should change so that neurosurgeons can develop their experience

EDITOR,--M C G Stevens and colleagues bring welcome, reasoned analysis to an emotive subject.1 In our attempts to optimise treatment for children with brain tumours in Britain it may be useful to bear in mind two factors that parents of children with tumours with a poor prognosis find particularly appealing.

Firstly, in the United States, partly because of the greater number of patients attracted by centres, a pattern of neurosurgical referral has developed that has enabled individual surgeons to build up unrivalled experience in the management of certain types of tumour. This compares with the more traditional British approach, whereby surgeons tackle whatever cases are referred to their centre. The British approach results in some children being operated on by surgeons who may not specialise in children's brain tumours, let alone have a specific interest in a particular type of tumour.

Secondly, Americans' positive attitude to problem solving is reflected . . . [Full text of this article]


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Relevant Article

Treatment for children with brain tumours
M C G Stevens, A D Hockley, D Spooner, and A R Walsh
BMJ 1995 311: 1213-1214. [Extract] [Full Text]

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