Re:Who decides, the Specialist and Expert, or the GP?
Thanks for your response and I am sure you express the views of many
colleagues. I would like to respond on a number of important points you
raise.
Firstly, you should know that I have written previously that
commissioning should involved GP and consultants. I find the government
proposal divisive and I very much believe in collaboration.
Secondly, I raised relevant points in my response to the experts
letter which I believe are absolutely correct. Should the consultants
wish to respond again, I am happy to explore this topic further in the
responses. Thus far they have chosen not to.
Thirdly, on the vexed issue of expert versus the uppity generalist. .
I am always willing to consider expert opinion. But this is not on the
basis of an expert "status" but only on the basis of their argument. I
understand the published evidence as well as they do but have a different
perspective from primary care. Much of what I was taught in hospital and
undergraduate is not relevant or is wrong and frankly unhelpful in the
community. So I , do "respect" but not "deference"; if this seems
"ignorant and arrogant", then so be it..
Experts over saw the banking collapse, the housing bubble, the
promotion of Vioxx, the over diagnosis of cancer in screening programmes
and in the past the promotion of cigarettes ! So I wouldn't always have
faith in experts and we need more dissent in medicine not less.
Who should decide on health care the consultant or the GP ? The
answer is both, and absolutely and fundamentally, equally.
Lastly, yes many rectal examination are pointless and have no
evidence base. Another "Bad Medicine" on its way.
Rapid Response:
Re:Who decides, the Specialist and Expert, or the GP?
Thanks for your response and I am sure you express the views of many
colleagues. I would like to respond on a number of important points you
raise.
Firstly, you should know that I have written previously that
commissioning should involved GP and consultants. I find the government
proposal divisive and I very much believe in collaboration.
Secondly, I raised relevant points in my response to the experts
letter which I believe are absolutely correct. Should the consultants
wish to respond again, I am happy to explore this topic further in the
responses. Thus far they have chosen not to.
Thirdly, on the vexed issue of expert versus the uppity generalist. .
I am always willing to consider expert opinion. But this is not on the
basis of an expert "status" but only on the basis of their argument. I
understand the published evidence as well as they do but have a different
perspective from primary care. Much of what I was taught in hospital and
undergraduate is not relevant or is wrong and frankly unhelpful in the
community. So I , do "respect" but not "deference"; if this seems
"ignorant and arrogant", then so be it..
Experts over saw the banking collapse, the housing bubble, the
promotion of Vioxx, the over diagnosis of cancer in screening programmes
and in the past the promotion of cigarettes ! So I wouldn't always have
faith in experts and we need more dissent in medicine not less.
Who should decide on health care the consultant or the GP ? The
answer is both, and absolutely and fundamentally, equally.
Lastly, yes many rectal examination are pointless and have no
evidence base. Another "Bad Medicine" on its way.
Competing interests: No competing interests