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APPENDIX II.
TUBERCULOSIS DISPENSARY.
REPORT FOR THE YEAR 1929.
By H. Tylford Howell, M.R.C.S., Eng., L.R.C.P., Lond.,
Clinical Tuberculosis Officer.
I am pleased to report that there has been no change in the personnel
of the Dispensary during the year.
In order to present a coherent statement of the work of the department
it will be necessary to recapitulate briefly what has been said in previous
reports with reference to the routine adopted.
The sessions have remained unchanged, patients attending on Monday,
Wednesday, Thursday, Friday, and Saturday mornings from 10 to 12 o'clock;
Wednesday evenings from 5.30 to 7; and Thursday evenings from 7.30 to
9 o'clock. Saturday mornings are reserved for school children and such
adults as find it impossible to attend at other times, and the evening
sessions are limited to patients who are at work during the day.
In order to reduce the period of waiting, patients are allowed to attend
any time during the session, and are seen in order of their arrival at the
Hospital, irrespective of whether they are new or old cases. The accommodation
at our disposal with regard to waiting-rooms, consulting-rooms,
dressing-rooms, etc., is ideal, and adds considerably to the smooth working
of the department, while the recent provision of an adjoining office for the
Dispensary Clerk has proved most convenient.
The adequate dressing-room accommodation obviates the necessity for
separate sessions for the sexes. It also ensures privacy, and makes it
possible to arrange that no patient shall be examined in the presence of
others, except members of the same family attending together.
The practice of two medical officers frequently consulting one another and
afterwards discussing special features and points of difficulty has many advantages.
It adds to their keenness, broadens their views, and the patient
obtains the benefit of a double opinion.
The opportunity for further consultations is, if thought necessary, also
available in the various departments of the Hospital. Thus the opinion of a
Physician, Surgeon, Laryngologist, Pathologist, or Dentist can be obtained
with little delay. Accordingly, cases can be thoroughly investigated on the spot
without loss of time, the routine examination of the patient, sputum examination,
and X-ray reports all being completed within twenty-four hours.
Personal consultation on individual cases, with the specialist concerned, is
of the greatest value; while the advantage of association with the Hospital
Staff cannot be over-estimated. Close clinical contact with others results
in frequent discussions and a friendly interchange of criticism, which obviously
act as a stimulant to careful work. However good an officer may be
at the outset, if the nature of his work is such that he is isolated from his
fellows he is sooner or later almost certain to lose his keenness, with a consequent
reduction of efficiency. This, of course, might be remedied to a
certain extent by periodic post-graduate courses of study.