Accident department or general practice?

Ninety two patients, who were registered with one general practice partnership that has a tradition of providing minor trauma services and who had attended a hospital accident and emergency department, completed a questionnaire giving their reasons for not first attending their general practitioners with their ailments. Most had not tried to contact their general practitioner, and of these, only a few were unsuitable for treatment first by the general practitioner. More than half had attended the accident and emergency department because they did not want to bother their own general practitioner or thought that their problem was unsuitable for his attention. A higher proportion had attended for reasons of perceived speed or convenience. In the light of the need to cut costs in the hospital service and of government interest in promoting a wider range of services in general practice further study of such problems is needed. Patients' perceptions of the role of the accident department need to be changed if present behaviour is to be altered.