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I must state I found it a little ironic after reading the editorial on the "Return of the corridors of shame" to then turn several pages and find this Author's reply in the letters section regarding the First trimester miscarriage article (BMJ 2013;346:f3676): "Ruptured ectopic pregnancy should be suspected in all pregnant women presenting with... unusual gastrointestinal symptoms. These women should be referred to the nearest emergency department without delay." (BMJ 2013;347:f4497)
Patients who have already been assessed by a General Practitioner and discussed with specialty teams such as orthopaedics, ENT and gynaecology are frequently told to attend the Emergency Department to be reviewed by the speciality doctor, with no thought being given to the resulting loss of ED rooms and nursing time.
Perhaps if other specialties would establish appropriate areas in which to accept and assess their own acute referrals, the Emergency Department would have more time and space to manage our own.