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106
Several patients were diagnosed in St. Giles' Hospital after
a period of observation. Apart from the above we had the opportunity
under the London County Council Tuberculosis Scheme of
getting patients admitted to special hospitals, for example Brompton
and High wood Hospitals for observation as to diagnosis and to
St. George's Home, Chelsea, among other Institutions for disposal
as to treatment.
2. With School Clinics.—All contacts of school age are referred
by the Dispensary to the Divisional School Medical Officer for the
area for special and periodical observation by the School Medical
Officers and any doubtful case may be referred back to the Dispensary
for special examination.
Arrangements made to secure Co-operation of Medical Practitioners
in the Work of the Dispensary.
The Tuberculosis Dispensary has been open for 20 years and
the pioneer task of making its opportunities and its work known
to the medical practitioners of the area is past. There still however
remains, and will always remain, the necessity of keeping the work
up to that standard by which medical men will judge its usefulness
to their patients. During 1932 the number of consultations with
medical practitioners was 793. On the 31st of December, 1932,
305 insured persons were under domiciliary treatment. During
the year 390 reports on domiciliary treatment were received from
local practitioners.
The following up of Patients in cases where the Diagnosis is doubtful.
The patient is asked to return. A mutually convenient date is
fixed. If the appointment is not kept an appropriate letter is sent
—one that is not unmindful of possibilities—the patient may be
confined to bed, or may have returned to work and so on. Letters
may be sent over and over again—as often as may be necessary.
A patient who feels that a real interest is being taken in his case
will—provided his illness is not a mere passing affair—seldom fail
to respond to a reasonable request to return for further examination.
There are exceptions. In every case the value of full co-operation
with the medical man who sent the patient for diagnosis is obvious.
We do not make use of the services of the Tuberculosis Health
Visitors for following up cases in which the diagnosis is in doubt.
Our Health Visitors are well-known in the area and patients
attending for diagnosis and who may of course eventually be
pronounced non-tuberculous might quite rightly cease to cooperate
if they felt that their visits to the Dispensary were not kept
as private as possible.