Clin Med
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The New Zealand junior doctors' strike provided an opportunity to consider strategies that might be employed to overcome the international shortage of junior doctors. This article reports the experience of the emergency department (ED) and internal medicine (IM) services at Wellington Hospital during the national strike, in which medical services were primarily provided by specialist consultants in addition to, or as part of, their routine work. During the strike, elective admissions and outpatient clinics were mostly cancelled. ⋯ Notwithstanding the different work circumstances, in both services one senior doctor carried the workload of at least two junior doctors. The deployment of additional senior medical staff to acute hospital services could greatly reduce the total number of doctors required. This strategy would have implications in terms of supporting acute medicine specialty initiatives, training, quality of care and funding.
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Respiratory disease contributes significantly to the workload of the acute medical take. This article, aimed at all physicians, reviews the evidence base for common respiratory conditions presenting as an acute emergency. There is particular emphasis on pleural disease and respiratory diagnoses likely to present with acute breathlessness.