BMJ  2003;327:918-919 (18 October), doi:10.1136/bmj.327.7420.918-a

Commentary

how can general practitioners aid prompt referral?

Pippa Oakeshott, senior lecturer in general practice1

1 Community Health Sciences, General Practice, St George's Hospital Medical School, London SW17 ORE oakeshot@sghms.ac.uk

The first 150 words of the full text of this article appear below.

Elisabeth is a first child so her parents have little experience of common childhood illnesses. In addition, her mother is an anaesthetist and may be reluctant to bother a general practitioner unless it is really necessary. Unusually, Elisabeth has had two episodes of a severe infection—periorbital cellulitis—for which investigation for immune deficiency may be indicated. Her parents seek advice after Elisabeth has been unwell for three days with fever, irritability, sore mouth, conjunctivitis, rash, and desquamation and has not passed urine for 24 hours. At this point there may have been some misunderstanding with the out of hours service, which should have advised that the child be seen by a doctor and would generally recommend follow up by the general practitioner next morning.

When the general practitioner sees Elisabeth on day 5 everything seems normal except the rash and perineal desquamation. Like some of the commentators, many general practitioners would . . . [Full text of this article]


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