One cause for the decline may be the fall in senior junior staff

BMJ 1995; 311 doi: http://dx.doi.org/10.1136/bmj.311.6996.60 (Published 01 July 1995) Cite this as: BMJ 1995;311:60
  1. W M Seymour
  1. Consultant physician Brook General Hospital, London SE18 4LW

    EDITOR,--David Armstrong and Mick Nicoll do not provide any evidence to justify their assertion that the average consultant saw 1680 new patients in 1949,1 a year in which the combined number of whole time specialist senior hospital medical officers and senior registrars exceeded the number of whole time consultants.2 It would be naive to believe that these staff did not have an important role in seeing outpatients. Since then the ratio of such senior junior staff to consultants has fallen to 1:3. The implication that because of this calculated reduction in consultants' average outpatient workload sufficient resources are available to meet the demands for additional outreach clinics without expansion in the number of consultants needs to be tested for the individual specialties concerned. For example, in 1949, 10.5 new dermatological patients were seen per clinic2--not, I suggest, very different from the situation today.


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