The British journal of general practice : the journal of the Royal College of General Practitioners
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This paper reports the first study of Australian emergency physicians which concentrates on their relationship with general practitioners. A self-administered questionnaire was mailed to every known fellow and senior trainee of the Australasian College of Emergency Medicine working in Victoria, Australia. Good response rates were achieved (97% from fellows, 78% from trainees). ⋯ The outcome for patients attending emergency departments with referral letters warrants study. If a good referral letter is seen to be of value in terms of more accurate diagnosis, quicker patient processing, less investigations and better responses, then general practitioners will be encouraged to write better letters. The results of this study offer a useful definition of inappropriate referral to the emergency department and it may now be possible to investigate any link between poor referral letters and inappropriate referrals.
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The immunization status of the children of Traveller Gypsies presenting to two general practices and a paediatric accident and emergency department in east London between July 1988 and February 1990 was compared with that of a control group presenting to the same services. Study of parental reports and other records for 72 Traveller Gypsy children and 106 control children aged 10 months to six years revealed that Traveller Gypsy children had significantly lower completion rates for pertussis, measles, diphtheria/tetanus and poliomyelitis vaccines than the control group. ⋯ The 1990 general practitioner contract and reforms to the health service may result in decreased access for Traveller Gypsies unless steps are taken by family health services and district health authorities to meet the health care needs of this group. Possible solutions to this problem include outreach services to caravan sites, opportunistic immunization, better records and targeted health education.