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“See and treat” is great—if you’re a general practitioner
  1. D Y Ellis
  1. North West Thames rotation, UK;

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    In today’s society people want everything instantly, including their medical care. See and treat provides that instant access to “primary care” with no need to wait. Do Castille and Cooke1 really think that anyone will wait three days to see their general practitioner (GP) when they can pop in to the emergency department and see a doctor instantly 24 hours a day?

    The public perception of see and treat will be that it is acceptable to come to the emergency department instead of going to your GP. This at a time when we are trying to persuade the public that only emergencies should come to emergency departments.

    As a specialty we have been struggling for more than 10 years to be recognised as emergency doctors whose specialist interest lies first and foremost in the management of the emergency be it adult, child, medical, surgical, etc. The minor injuries that are emergencies constitute an interesting and often valuable sub-specialty but are not our raison d’etre. Trailing behind minors are the primary care cases and the triage category fives for whom we are now trying to resource a priority see and treat service. This has got to be the diametric opposite of emergency medicine and as such should not be a part of any major plan on reforming emergency care. The concept of see and treat is reasonable but if it is to work, we must totally isolate it from the emergency department and make it a primary care service, run by primary care doctors.

    If we continue our blinkered charge ahead with this initiative then emergency departments running see and treat will effectively simply become rapid access primary care centres. I’m sure the government will be very pleased and that local GPs will not mind but it will be a mortal blow for emergency medicine.

    It is interesting that there seems to be a rumour going round that only those who have not tried see and treat are complaining about the negative effect it has on job satisfaction. For the record, I am currently doing see and treat and my job satisfaction during these periods is negligible.