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The bell tolls for the infectious diseases clinician
Journal of Infection (1986) 13, 209
Abstract of literature THE BELL TOLLS FOR THE INFECTIOUSDISEASES CLINICIAN. Ervin FR. ff Infect Dis 1986; 153: 183-185. T w o COMMENTS IN RESPONSE. Berman SJ, J Infect Dis 1986; 153: 185-186, and Ackley A, Jr. J Infect Dis 1986; 153: 186-188. WHITHER INFECTIOUSDISEASES?MEMORIES, MANPOWER,AND MONEY. Petersdorf RG. J Infect Dis 1986; I53: 189-195. Petersdorf RG. I n 198o Dr Paul Beeson stated that the speciality of Infectious Diseases lacked every attribute needed for successful practice - special technology, chronic disease, and (an especially American concern) balanced remuneration. In the U.S.A., Infectious Disease clinicians offer a predominantly referral-orientated clinical service, often combined with laboratory duties. The problem which the American Infectious Disease practitioners are facing is simple: in a time of tight financial control the non-academic clinicians are not getting the referrals from which to make a living - 'we are at the bottom of the imbalance of reimbursement for cognitive skills'. The prospects for young American Infectious Disease-trained clinicians outwith academic centres appear bleak. Interestingly, new diseases are mentioned, including Legionnaires' disease, A I D S , infections caused by methicillin-resistant Staphylococcus aureus, Clostridium difficile colitis, opportunistic infections, and Lyme disease. T h e inference this reviewer draws is that the American Infectious Disease fraternity has not adopted A I D S as their own disease, possibly because they do not, in general, have their own hospital beds. This is curious because AIDS patients have a disease both caused by, and causing infection. Reading these papers made me realise the value of the U.K. system of training in which Infectious Disease physicians, by contrast, have a foundation of general medical training and their own hospital beds but rarely laboratory responsibilities. The truth of the matter, stated by Dr Petersdorf, is that 'most infectious diseases should and can be handled by a generalist whether he/she is an internist, a paediatrician, or a family physician'. Quite right.
P. D. Welsby
Abstract of literature THE BELL TOLLS FOR THE INFECTIOUSDISEASES CLINICIAN. Ervin FR. ff Infect Dis 1986; 153: 183-185. T w o COMMENTS IN RESPONSE. Berman SJ, J Infect Dis 1986; 153: 185-186, and Ackley A, Jr. J Infect Dis 1986; 153: 186-188. WHITHER INFECTIOUSDISEASES?MEMORIES, MANPOWER,AND MONEY. Petersdorf RG. J Infect Dis 1986; I53: 189-195. Petersdorf RG. I n 198o Dr Paul Beeson stated that the speciality of Infectious Diseases lacked every attribute needed for successful practice - special technology, chronic disease, and (an especially American concern) balanced remuneration. In the U.S.A., Infectious Disease clinicians offer a predominantly referral-orientated clinical service, often combined with laboratory duties. The problem which the American Infectious Disease practitioners are facing is simple: in a time of tight financial control the non-academic clinicians are not getting the referrals from which to make a living - 'we are at the bottom of the imbalance of reimbursement for cognitive skills'. The prospects for young American Infectious Disease-trained clinicians outwith academic centres appear bleak. Interestingly, new diseases are mentioned, including Legionnaires' disease, A I D S , infections caused by methicillin-resistant Staphylococcus aureus, Clostridium difficile colitis, opportunistic infections, and Lyme disease. T h e inference this reviewer draws is that the American Infectious Disease fraternity has not adopted A I D S as their own disease, possibly because they do not, in general, have their own hospital beds. This is curious because AIDS patients have a disease both caused by, and causing infection. Reading these papers made me realise the value of the U.K. system of training in which Infectious Disease physicians, by contrast, have a foundation of general medical training and their own hospital beds but rarely laboratory responsibilities. The truth of the matter, stated by Dr Petersdorf, is that 'most infectious diseases should and can be handled by a generalist whether he/she is an internist, a paediatrician, or a family physician'. Quite right.
P. D. Welsby