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The Dispensary as a Centre of Diagnosis.
During the last ten years medical men have sent, each year,
on an average about 700 new patients to the Dispensary for diagnosis,
During 1922 they sent 607 new patients for that purpose, as compared
with 750 in 1920 and 662 in 1921. The drop in numbers, though
considerable, does not apparently mean that this part of the work
is less appreciated, as at the time of writing (May, 1923) the numbers
for the first four months of 1923 show a marked increase. The
above numbers are evidence of a fair amount of co-operation between
the Dispensary and local practitioners. It may be mentioned in
this connection that, apart from the above new patients, local
practitioners sent hundreds of patients who had attended the Dispensary
in previous years for further consultation.
The function of the Dispensary as a centre of diagnosis has
been mentioned above. The total number of new patients who
came to the Dispensary for diagnosis in 1922 was 1,656, and a further
161 new contacts were examined at their homes and did not attend
the Dispensary. Tuberculosis Officers are frequently faced with
difficult and anomalous cases. In such cases the value of team work
must not be forgotten. During 1922, 213 patients were sent to
various departments of King's College Hospital for consultation,
and we are indebted to the physicians and surgeons of that hospital
for the help they gave. Other patients were admitted for diagnosis
to observation beds in Brompton Hospital and the City of London
Hospital, Victoria Park, under the London County Council Institutional
Scheme. Patients were also admitted to Camberwell
Infirmary for observation and to Orpington Hospital (Pensions
Ministry cases) for the same purpose. During 1922 Camberwell
ex-service men suffering from tuberculosis or suspected to be suffering
from that disease were sent by the Pensions Ministry to the
Dispensary for reports on diagnosis and progress of pensionable
condition in connection with re-assessment of pensions. Tuberculous
ex-service men were sent to the Dispensary by the Local
War Pensions Committee for examination and report as to fitness
for work or for treatment allowances.
The Arrangements for following up Patients in Cases
where the Diagnosis is doubtful.
The Ministry of Health desire information on this point in
reports on dispensary work. It is a root matter. If doubtful
cases are not followed up until a definite decision is made the
standard of the Dispensary as a centre of diagnosis must be considered
as below par. It is true the following up process may fail,
but the failure should be entirely on the part of the patient. A
Blackwood's one day diary with the date of the next examination
carefully recorded is satisfactory if the patient is given a card on