Part II of Patients Suffer When Consultant & Consultee Beg to Differ
A. Mark Clarfield, MD
For those FRCPC's who felt aggrieved by my last month's column, take heart. In this month's column, I shall address the sins of the CCFP consultee. I am attempting this here because these examples of malfeasance pertain most especially to the elderly--patients who are the most vulnerable when caught in the crossfire between those that seek and those that give advice.
As I mentioned in my last epistle on the subject of consultation, the older person tends to have multiple, chronic diseases that may present atypically, often making it difficult, at least at first, to make an accurate diagnosis. As a result, many elders are subjected to the perils of polypharmacy. In addition, older patients, when admitted to hospital, have an increased length of stay and often present with a more complicated history than their younger counterparts. Thus, appropriate consultation is of great importance to the older patient.
I will now endeavor to discuss the mistakes in the consulting practices of Canada's family doctors, especially with relation to the geriatric patient.
I feel well qualified to write on the subject, since I practiced family medicine for several years before becoming a geriatrician. During this period, I committed all (and perhaps more) of the obliquities that are discussed below.
