Editorials

Open access

A specialist ought to be someone who, by virtue of training and experience, can assess and advise patients and referring doctors with the optimum--which often means the minimum--use of investigations. A specialist whose main function is ordering tests is simply acting as a middle man (or woman) between the general practitioner and the service department, and such intermediaries can usually be dispensed with. With open access to hospital investigations general practitioners can dispense with some specialists, and, unsurprisingly, open access has not been universally welcomed as a proper means of offering health care.

Of course, some investigations must be reserved for specialists. These include invasive procedures entailing risk and requiring dexterity and those that are either very expensive or very time consuming (and hence need rationing by specialists, who know which patients are most likely to benefit). Few . . . [Full text of this article]

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Relevant Article

General practitioners also use open access computed tomography wisely

Patrick M Strong and Robert J Walker
BMJ 1995 311: 325-326. [Extract] [Full Text]

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