The Doctor

Abstract

Some doctors are generalists (the family doctor or general practitioner) while others are specialists (the hospital consultant, the expert surgeon). The normal system is for primary care to be the first step, and for the family doctor then to act as the gatekeeper who refers the case upwards if it requires attention more sophisticated than he or she personally can provide. Sometimes, however, the patient goes in the first instance directly to the specialist (a familiar scenario in the case of the dentist, the optician or the psychiatrist); and sometimes, too, the general practitioner has some specialist expertise (to such a standard, indeed, that he might himself be capable of treating the patient in hospital). There is no hard-and-fast rule that the generalist and the specialist should be separate breeds, but this is the most common system.