BMJ  2006;333:136-137 (15 July), doi:10.1136/bmj.333.7559.136-a

Commentary

A fairytale ending?

¹ Hillhead Family Practice, Belfast BT11 9FZ domhnall.macauley@ntlworld.com

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

"And they all lived happily ever after," happens only in fairy tales. The clever hospital doctors have made a fascinating physiological diagnosis, and the patient has stopped vomiting and returned to normal life. Cured. Wouldn't it be great if life was like this all the time? Most general practitioners will suppress a wry smile, knowing that this is likely to describe a chapter in Mr Neville's life.¹ His general practice file is already substantial, and his hospital notes bulging. The pattern of morbidity leading up to this admission is perhaps likely to continue long into the future.

Our hospital colleagues can enjoy the triumph of their diagnosis aided by the latest technological advances: manometry and multichannel intraluminal impedance. We would not have made the correct diagnosis. Of course not. But most general practitioners would have spotted the warning signs that there was something not quite right. The phrase, "He was . . . [Full text of this article]

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