General practitioners also use open access computed tomography wisely

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7000.325c (Published 29 July 1995) Cite this as: BMJ 1995;311:325
  1. Patrick M Strong,
  2. Robert J Walker
  1. Consultant radiologist General practitioner Bolton Medical Institute, Bolton BL1 4OS

    EDITOR,--In their editorial J R Hampton and A R Barlow claim, “Few doctors want … open access computed tomography for headache.”1 In Bolton direct referral for computed tomography by general practitioners has been available for the past two years; the waiting time for an appointment with a neurologist has recently fallen to 16 weeks. The normal procedure is for the general practitioner to discuss the case with a radiologist on the telephone. Obviously there must be some doubt about the cause of the headache. If the patient has neurological signs associated with the headache then the advice is to refer the patient to a specialist rather than for scanning so that the specialist can investigate as he or she sees fit. If the general practitioner is sufficiently concerned to refer the patient even if the scan shows no appreciable abnormality then the advice is the same.

    There is no evidence of abuse. One hundred scans have been requested by general practitioners in the period. No one has requested more than nine scans. The waiting time for an appointment for scanning as an outpatient is one week, regardless of the source of the referral.


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