Williams B T, Dixon R A, Knowelden J
Br Med J. 1973 Mar 10;1(5853):593-9. doi: 10.1136/bmj.1.5853.593.
Seventy-four per cent. of Sheffield general practitioners and 78% of those in Nottingham used a deputizing service in 1970. In each city the deputizing service was used by about 80% of single-handed general practitioners, 90% of doctors in two-doctor practices, and 60% of those in partnerships of three or more.The Sheffield deputizing service handled 15,988 new calls in the year, an average of 106 per subscribing doctor, and in addition made 339 revisits. The median number of calls handled for single-handed doctors was 98, for those in two-doctor practices 95, and for those in partnerships of three or more 75. The growth of group practice has not eliminated the demand for deputizing services.Sixty-six per cent. of consultations were with deputies who were primarily hospital doctors, 20% with a full-time deputy, 11% with deputies who were primarily general practitioners, and 3% with the switchboard staff, who were also trained nurses. The deputies had been qualified, on average, for eight years. Seventy-two per cent. of patients attended were seen within one hour of receipt of the call.Calls handled by the deputizing service represented approximately 1% of all the subscribers' consultations, 5% of their home visits, and half their calls between midnight and 07.00 hours. At this level of activity the concept of "personal doctoring" was not threatened.
1970年,谢菲尔德74%的全科医生以及诺丁汉78%的全科医生使用了代理服务。在每个城市,约80%的个体全科医生、90%的两人诊所医生以及60%的三人或更多人合伙诊所的医生使用了代理服务。谢菲尔德的代理服务在这一年处理了15988个新呼叫,每位订阅医生平均106个,此外还进行了339次复诊。个体医生处理的呼叫中位数为98次,两人诊所医生为95次,三人或更多人合伙诊所的医生为75次。团体执业的发展并未消除对代理服务的需求。66%的会诊是与主要为医院医生的副手进行的,20%与全职副手进行,11%与主要为全科医生的副手进行,3%与总机工作人员进行,总机工作人员也是经过培训的护士。副手平均已获得资格八年。72%的就诊患者在接到呼叫后一小时内得到诊治。代理服务处理的呼叫约占所有订阅医生会诊的1%、家访的5%以及午夜至07:00之间呼叫的一半。在这种活动水平下,“个人医疗”的概念并未受到威胁。