Læknablaðið - 01.08.1972, Blaðsíða 62

92
LÆKNABLAÐIÐ
hús þannig, að öll aðstaða, húsakynni, tæki og starfslið nýtist sam-
eiginlega og allar upplýsingar um sjúklinga liggi fyrir á einum stað.
En, meðal annarra orða, (hér táknar dreifbýli allt landið utan
Stór-Reykjavíkur) — er ekki þörf nýrrar samþykktar, þar sem orðið
dreifbýli er fellt niður?
Það hefur vafizt fyrir mönnum á hvern hátt verði bezt komið
fyrir samstarfi heimilislækna og sérfræðinga innan veggja sjúkra-
húsanna. Við verðum að finna lausn á því vandamáli. í þessu sam-
bandi vil ég benda á rit, sem er forvitnilegt öllum þeim, er áhuga
hafa á þessum hlutum: Doctors in an Integrated Health Service.3)
Leyfi ég mér að birta 4 tilvitnanir úr því riti:
1. (57) Perhaps the most difficult problem in the develop-
ment of general practice lies in re-establishing the general
practitioner’s position in hospital. The profession has become
so accustomed to the ‘closed’ staffing situation of our urban
hospitals, that it will be difficult for many general practitioners
to change their outlook and for specialists to forego some of
their monopoly of in-patient care and hospital-based diagnostic
resources. But it is necessary to tackle the problems. In our
view, the hospital has become so significant as a centre of pro-
fessional stimulus and ideas that it is dangerous to cut off any
substantial body of clinicians from its influence and resources.
Involvement in the care of their patients in hospital can provide
general practitioners with the sort of challenging environment
in which they can best develop their knowledge and skills.
2. (61) Another possibility is an arrangement whereby the
general practitioner admits his patient and looks after him
within the specialist ward. This type of arrangement is so rare
in this country that there is as yet virtually no evidence of
how it would work in Scotland. No doubt there would be many
practical difficulties to overcome. The multiplication of doctors
in the ward would provide problems for the nursing and junior
medical staff and it might be difficult to preserve the general
practitioner’s full responsibility for a patient who was side by
side with other patients under specialist supervision. But we
feel strongly that such arrangements cannot be dismissed as
impracticable without trial.
3. (76) In Chapter III we have already indicated how we
think the general practitioner should be brought into the acute
hospital to care for those of his own patients whose diagnosis
and treatment require the professional and technological ser-
vices of the hospital, but not necessarily the direct supervision
of a specialist. We envisage that such arrangements will be the
commonest way in which the general practitioner has contact
1) Scottis Home and Health Department. Report of a Joint Working
Party. [H M Stationary Office]. 1971.