Intended for healthcare professionals

Rapid response to:

Feature Data Briefing

Are accident and emergency attendances increasing?

BMJ 2013; 346 doi: (Published 07 June 2013) Cite this as: BMJ 2013;346:f3677

Rapid Response:

Re: Are accident and emergency attendances increasing?

The phenomenon of an increase in Accident and Emergency attendances(1) might be an example of Sutton's law. William Sutton is the gangster credited with the saying "because that's where the money is", when asked why he robbed banks(2). Likewise, as a result of the perception that "the clinical examination is dead"(3), discerning patients might be deserting their general practitioners and flocking to Accident and Emergency(A&E) departments because they recognise that A&E is the gateway to where high-tech diagnostics are to be found. Accordingly, the perception that their own doctors are not performing the clinical examination expected of them might partly explain why patients themselves have lost faith in the clinical examination, and this sense of disillusionment might have contributed to the accelerated stampede to A&E.
(1) Appleby J
Are accident and emergency attendances increasing?
BMJ 2013:346:f3677
(2) Rytand D
Sutton's or Dock's law
New England Journal of Medicine 1980;302:972
(3) Patel K
Is clinical examination dead?
BMJ 2013;346:39

Competing interests: No competing interests

09 June 2013
oscar,m jolobe
retired geriatrician
manchestr medical society
simon building, brunswick street manchestr M13