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Dear Editor,
As a GP I often see illness present and develop over a period of time. GPs have to ensure they keep in touch with patients while this happens , often with no definite idea of diagnosis or the next steps. The cardinal symptoms can bubble and change often turning the pathway plans upside down only to be turned again. Many referrals are for clear cardinal and isolated symptoms with the out patient destination clear. The next steps for the consultant are usually clear in such patients. But many presentations are not like that and are ill served by one out patient contact (of course after months of waiting). The out patient system has non iteration built into it. This can lead to specious investigation and embarkation on the wrong pathway or premature discharge back to the referrer with no real meaningful progress made.
Re: New and follow-up outpatient appointments are out of date concepts
Dear Editor,
As a GP I often see illness present and develop over a period of time. GPs have to ensure they keep in touch with patients while this happens , often with no definite idea of diagnosis or the next steps. The cardinal symptoms can bubble and change often turning the pathway plans upside down only to be turned again. Many referrals are for clear cardinal and isolated symptoms with the out patient destination clear. The next steps for the consultant are usually clear in such patients. But many presentations are not like that and are ill served by one out patient contact (of course after months of waiting). The out patient system has non iteration built into it. This can lead to specious investigation and embarkation on the wrong pathway or premature discharge back to the referrer with no real meaningful progress made.
Competing interests: No competing interests