hydmchloride, and-pizotifen). -. Thus, in almost one.third of thb patients who were on drugs the infoation supplied by- the referring doctor was incomplete.
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tthat- doctors are not suitable to be idminithat is the electrocardiogriphicdreading.-IT fact that a patient has hypertension does not change strators ad, secondly, tO CODn d to t athey speclisd trathat-reading. Howiver, -the ined cincin wih confldencein the historyand bloodpssures alues i)g--Damition Ei yn rlater dter-e may then conclude that left ventricularhyper- no doubting the success of the collge in achieving ; trophyis more likely I now blieve : there is j f.urher phase in the DAvIDH SPODucx University of Mshus Medil School, developmenof medical administon_, that of the St Vincn Hopital,, cliician, who, because of the compleity of the Worcese, MA01604 healtl care system and the or pntion of hospiUSA tals, need a ugh grounding in manial I Spodic I's. o Minimize inteever difference C_wadane skills if- they are to opereecieit a 1976;54:698-9. m t or otherhealhcarelat 2 Spodic DI nI epetmand experie: The ffect of vanbility hospidip The dCMAhastecemtlybeena p ofi in observer perfomance. AmY Cardi 1975;36:526. fQr ettin the voima clincnsv by runnmng one r two dy propam1X ikicas on adoiinistae sk~illso roa nformingthe hospital of paients' drug :The course is designed for prcttodr whos regimens interests are primariy cii yt who want to SIR,-Dr Charles Claou6 and Mr A R E'kington braden- hek knowledge of issues aed to and to i more eectively in reported(11 January,p IO1)aamarkedisdreancy a -nI' ngeri roles. between the number of drug, the geieal practitioners recorded and those the patient wa actually In- aery shoriiime healthfcar Merictillfneed ias Who also anid shiid have on their staff taking. -in a small st6dy ossess a number of management skills. Thi- will I found a similar discr withinthehealth undertaken in a catdiac outpetiet clHinC. Over six enhance bothhirown e months all new-patients completed a questionnaire servce and that of the helth service it which- ifnude the heading: "Present treatment - ; - : ~TJWoon -please ndae down any tablets or meicines you Alfied Hspital, are taking." I' `onaied- the patients' lists with Pthra 3181, those supplied by the'eferring- general practi- Victorian tioners, most of whiom used the standad reedal Austalia form, which has a specific secton for listing th1 I Waten H. -Mana_t training Sfr linicians. Br, MdI' drugs the patient is takig. 1985m21:1294-5. nii: Auslian 'Of % consecutive patients, 59 stated that they 2 Woed TJ,Tholn SE. Me viewpont. Lw 1985;5ii :556-7. were taking one or more diugs. I 41 of thesiecases the list given by the genal practitioner agreed with that of the patient, but in iS cases the information given- in 'the--eal etter was in- Miive bladder haemorrka-e complete. Infourcasesthere*isnomentiosofthe fact that the patient was on a diuti, and in two Si, Unlike Dr J A Murray and colleagues (4 odier cases there was no mention of other cardiac JaPnuary,P 57),we support the views of Mr Nigel Block and Mr Robert H Whitte on the drugs (isosorbide and timolol). Other included sedatives of aiolytics in five case, disadrssztages of intravesical formalin for massive analgesics in three, and a variety of other drugs in bladder 1~aethorrhage
