I don't engage with Caldwell
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Als antwoord op @mancunianmedic @csubbe en
This is interesting. I think acute medicine is moving ever closer to the front door. The AMU is becoming more like short stay and I'm inclined to agree that clear 'speciality' admissions should go direct to wards. Maybe that's all just my personal preference?
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Als antwoord op @drruthjohnson @mancunianmedic en
Agreed. The caveat being the pre-labelled patient and risk of ending up under completely the wrong specialty: isn’t there work from Europe (in systems without EM at the time) that found this
mortality? I’m sure I recall hearing that.2 antwoorden 0 retweets 7 vind-ik-leuks -
Als antwoord op @DrLindaDykes @drruthjohnson en
Yes-I think I’ve seen this-will try and dig it out. The problem for me is that patients very rarely present with just a single problem and generalism and its ability to look and treat wider should be celebrated. 1/2
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Als antwoord op @SueManby @DrLindaDykes en
2/2 I see your point Ruth but I don’t think (hope) that you think AIM physicians are non specialists? And that we are expert in stabilising and diagnosing acute illness? Do you mean we should work in ED, at the front door?
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Als antwoord op @SueManby @DrLindaDykes en
Hogwarts had one sorting hat in one place Does patient need acute hospital care? Yes, keep at Hospital Need urgent care now? Yes - do it in Resus No - assess rapidly and move on to the best team best place for that patient with fewest bed moves for patient & staff
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Als antwoord op @doctorcaldwell @SueManby en
That’s great with a straightforward presentation. No good at all for the non specific presentation. Maybe one day
@replynickel#secretingredient might help
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Als antwoord op @DrLindaDykes @SueManby en
There will always be a small proportion of patients not obvious which speciality to send onto and a small number who later prove to have been sent to incorrect ward Diagnosis is not straightforward
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Als antwoord op @doctorcaldwell @DrLindaDykes en
Every time we measure it, only 35-40% of patients have a very clear cut specialty destination, plus another 15-20% that are clear cut acute frailty/MDT-type admissions. That leaves 40-50% that is multi-morbidity complex GIM (obviously including many non-frail elderly)
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Als antwoord op @chrisbiggin @DrLindaDykes en
I couldn’t keep up with the unrelenting short term work of
#AMU but that’s me. I believe we need more Consultants in General Internal Medicine on the Wards and in Clinics2 antwoorden 0 retweets 1 vind-ik-leuk
We need on take ward rounds. The post take culture is useless to patients, highly stressful to juniors, and creates aloof peacocked seniors. Why in the world must everything start at the click of consultants' fingers, who often don't even turn up on time...adding to the nonsense
Het laden lijkt wat langer te duren.
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