With more member states around the table, maybe the practice of specialist councils will be a first (and useful) victim of expansion.
The attitudes and practice of specialist physicians, family physicians and physical therapists have been previously investigated [ 4- 7].
However, to develop effective, informative training, we first have to gain insight into the daily practice of specialist paediatric asthma care for ethnic minority patients.
The emerging supernumerary GP supervisor or GP consultant teacher model in some ways replicates the practice of specialist consultants in a teaching role in the public hospital environment.
Dual practice of specialists could be allowed but regulated, so that specialists dedicate a specified amount of time to treat local consumers.
This has been shown to improve the distribution of general practitioners, but has had less impact on the choice of location of practice of specialists, particularly those whose practice requires access to technology available only in specialized hospitals.
A randomized controlled trial (RCT) comparing primary-care-centred follow-up of breast cancer patients with the current standard practice of specialist-centred follow-up showed no increase in delay in diagnosing recurrence, and no increase in anxiety or deterioration in health-related quality of life.
Greater than 75% of GPs using the service were satisfied with the prescribing practices of the specialist services with some variation between the two hospices.
It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities.
But the nature of the response and the sense of ownership of this problem to challenge working practices within primary care itself rather than the practices of the specialist mental health sector varied from site to site.
