Osteosynthesis and Trauma Care 2006; 14(1): 1-4
DOI: 10.1055/s-2005-872549
Review Article

© Georg Thieme Verlag Stuttgart · New York

Functioning of A&E Doctors: Baseline Measurement in a Dutch University Hospital

S. Muller1 , S. de Weerdt1 , E. S. M. de Lange-de Klerk2 , B. Veenings1 , P. Patka3 , F. C. Bakker1
  • 1Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands
  • 2Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
  • 3Department of Trauma Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
Further Information

Publication History

Publication Date:
02 March 2006 (online)

Abstract

Aim: The aim of this study was to evaluate the functioning of junior doctors working in accident and emergency (A&E) departments. Methods: The data of all patients treated by junior doctors at an A&E department over a 3-week period were collected. Diagnosis and treatment were verified on the basis of the outpatient diagnosis and treatment; patients who were discharged or referred to their general practitioner were asked to complete a standard questionnaire. The number of requests for laboratory or radiography investigations was also recorded, and patient satisfaction was evaluated. Results: Of the 1108 patients examined by junior A&E doctors, 791 (72 %) were also treated and discharged by these doctors. Laboratory and radiographic investigations were requested for 220 (20 %) and 492 (44 %) patients; of these investigations, 119 (54 %) and 206 (42 %) revealed abnormalities, respectively. In 1 % of patients the correct diagnosis was not established. Conclusions: The traditional junior A&E doctor is capable of treating patients or of referring them appropriately without making excessive use of diagnostic investigations. If the function of A&E doctors is to distinguish between patients who need specialist medical care or who can be treated in, and discharged from, the A&E department, then possibly these doctors do not require extensive specialist training.

References

  • 1 Arnold J L. International emergency medicine and the recent development of emergency medicine worldwide.  Ann Emerg Med. 1999;  33 97-103
  • 2 Brunswick J E, Ilkhanipour K, Seaberg D C, McGill L. Radiographic interpretation in the emergency department.  Am J Emerg Med. 1996;  14 364-368
  • 3 Geloven A AW van. Spoedeisende hulp bij buikklachten. Evaluatie van het functioneren van de spoedeisende hulpafdeling aan de hand van patiënten met buikklachten. Universiteit van Amsterdam, Nederland 2000
  • 4 IJzermans C J, Mentink S, Klaphake L MM, Grieken J JM van, Bindels P JE. Contacten buiten kantooruren: klachten gepresenteerd aan de huisarts en aan de Spoedeisende Hulp.  Ned Tijdschr Geneeskd. 2002;  146 1413-1417
  • 5 Jaarsma-van Leeuwen I, Hammacher E R, Hirsch R, Janssens M. Patiënten zonder verwijzing op de afdeling Spoedeisende Hulp: patientkarakteristieken en motieven.  Ned Tijdschr Geneeskd. 2000;  144 428-431
  • 6 Kooiman C G, Wetering B JM van de, Mast R C van der. Clinical and demographic characteristics of emergency department patients in the Netherlands: a review of the literature and a preliminary study.  Am J Emerg Med. 1989;  7 632-638
  • 7 Lufkin K C, Smith S W, Matticks C A, Brunette D D. Radiologists' review of radiographs interpreted confidently by emergency physicians infrequently leads to changes in patient management.  Ann Emerg Med. 1998;  31 202-207
  • 8 Netten P M, van der Zee P M, Bleeker M WP, Smulders C. De eerste lijn voorbij.  Medisch Contact. 2002;  3 87-89
  • 9 Richards P J, Tins B, Cherian R, Rae F, Dharmarajah R, Phair I C. et al . The emergency department: an appropriate referral rate for radiography.  Clin Radiol. 2002;  57 753-758
  • 10 Riet Y EA van, Schouw Y T van der, Werken C van der. Minder rontgenfoto's en toch goede klinische zorg door geprotocolleerde fysische diagnostiek bij enkelletsels.  Ned Tijdschr Geneeskd. 2000;  144 224-228
  • 11 Vries G MJ de, Luitse J SK. Spoedeisende geneeskunde als specialisme. Drie modellen vergeleken.  Med Contact. 1999;  54 204-206
  • 12 Vries G de, Zwartsenburg M. SEH-artsen in Nederland: spoedeisende geneeskunde serieus genomen.  Triage. 2002;  5 12-15

Dr. F. C. Bakker

Department of Trauma Surgery · VU University Medical Center

P O Box 70 57

1007 MB Amsterdam

The Netherlands

Phone: +31/20/4 44 45 54

Fax: +31/20/4 44 02 74

Email: fc.bakker@vumc.nl

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