The Health Team

Abstract

Throughout the world definitions of family/general practice contain phrases like ‘family care’ and ‘continuous, ongoing, comprehensive care’. At the same time, with the progressive development of technical skills, there is increasing fragmentation of services and an increasing number of agencies which offer their particular ‘thing’ to the community. Often there is duplication of services; there is no coordination and most agencies make no commitment and have no responsibility for a comprehensive health service. Along with these developments is the appearance of ‘lock-up’ general practices where a doctor may live far away from the practice area, commute to work, open the ‘shop’ from 9 a.m. – 5 p.m. on weekdays and make no house calls. To meet the gap, emergency and crisis services are being created, usually for the transport of patients to base hospitals where diagnosis and treatment is, hopefully, provided. It is not only the victims of motor vehicle accidents and catastrophic life-threatening conditions that are being taken to hospital, but also people with remediable breathing difficulties or chest or abdominal pain, or even minor conditions such as sore throat and ear infections. The accident and emergency departments take on the look of a general practice. The doctors are usually inexperienced in this kind of work and have nothing more than a transient relationship with the patient.