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?
(2) Rytand D
Sutton's or Dock's law
New England Journal of Medicine 1980;302:972
(3) Patel K
Is clinical examination dead?
Competing interests: No competing interests