Community Clinic

This week when we eventually got back, we have been sent into the community. I have been placed in a clinic in near by obo. The community clinic works like a gp in England although it has less of a role in chronic disease management. Patients (called clients for some reason) visit the clinic when they feel like it. This is great for them but somewhat inconvenient if you're trying to fill a whole clinic. It had results in a lot of sitting reading for me (which is not necessarily a bad thing as the clinic has a lovely veranda under which to sit) waiting for patients to appear, and then suddenly its really busy and the nurse feels she should take over and stop translating. It can get quite frustrating.
The medicine practised is also unlike a gp because there are no investigations. Everything is done on history with a limited clinical exam if deemed necessary. Patients come in, get a diagnosis and leave with a bag full of drugs. Everyone gets all of these, which is hard to believe since no suspicions are confirmed by tests and the drug formulary is really limited. I suppose this in a way answers Mr Boles' question. I think more diseases are treated on less evidence rather than increased clinical expertise. I'm not saying that the level of the doctors here is any worse than at home, just that they have a much harder job. It's easy to sit in clinic questioning why everyone is being over treated but without the back up of hard evidence to the contrary on pretty much most diseases you can't be too hard on them for treating just in case.

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