The GP’s Lament (reproduced from BGS Newsletter, Sept 1996)

We must challenge the concept of geriatric medicine as a hospital-based specialty when it is the broadest of disciplines in which General Practitioners play an important role by practising in real and formative communities where the functional capacity and living conditions of people can be observed. There we become acquainted with the genetic background, ethnicity, and educational level of those on the practice list as well as their previous occupations and the modus vivendi which is lost, when admitted elsewhere.

I recall vividly one of my Trainees, after some years in hospital practice where he had passed the MRCP, laughing to see many healthy octogenerians, in contrast to the stroke and failing hearts he had come to regard as the norm for old age. While hospital doctors concentrate on the functional assessment and rehabilitation, GPs are not unacquainted with assessment procedures such as the Barthel Index, mobility grading scales etc. Nor are rehabilitation facilities confined to hospital practice.

There are a number of GPs who have made notable contributions to the study of eldercare - Idris Williams, Alastair Tulloch, Denis Pereira Gray, Ian MacIntosh, to name but a few. We cannot ignore the work of these thinkers. When I came into practice many years ago, the hallmark of good practice was the care of children, while the elderly were treated with elegant neglect, and my special interest was treated as a joke. Today, childbirth is a social event not, as then, a pathological landmark.

The BGS’s aim of ‘obtaining feedback on possible future directions and activities’ must involve the recruitment of enthusiastic and able GPs.

M Keith Thompson FRCGP (Deceased)

What a long way we have come since Dr Thompson wrote this letter, and what a pity he isn’t around to comment on current developments!

The Editor

Ann Homer
Exeter

Dear Editor

This article about the Evercare Health Group (BGS Newsletter July 2003) is a bit odd. The GP press had a report a few weeks ago about millions being spent on flying in experts from the USA to train up PCTs to look after their elderly. It must be the same outfit? I cannot believe that the BGS thinks this is desirable or necessary. Surely we have the expertise to do this in house - here in the UK, where geriatrics started. There are probably lots of good projects already going on around the country, involving existing staff (i.e. district nurses and practice nurses). Why doesn't the BGS find out? We have been doing high risk identification and active management in Mid Devon PCT for years. I bet there are others. Sorry to rant, it just seems such a waste of money.

Ann Homer

The Editor welcomes letters from readers, covering topics published in any issue of the Newsletter, or current affairs in the area of medical and social care for older people.

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British Geriatrics Society
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