Out-patient Gynaecology

The study was carried out in the out-patient department of the Obstetric Hospital, University College Hospital, from June 1, 1953, to May 31, 1954. A sample was drawn from the total number of patients applying for consultations at the hospital during the year. The reception staff took two patients from those telephoning for an appointment in each week of the year, except for holidays, and entered their names for the clinic held on Wednesday afternoons. At the time of entry the receptionist knew nothing of the patient except her name, and the only selective factor here was the patient's willingness to attend on a Wednesday afternoon. At the clinic, the two observers sat in adjoining rooms; each saw one patient, and the patients were then changed over. It was explained to each of them that she would see two doctors, one of whom would perform a gynaecological examination. The patients accepted this arrangement without dismay. Only one of the whole series inquired into the reason for it. One of us (N. M.) took a history and made a physical examination. The other made an appraisal of the woman's medical and psychiatric state. The two examinations were made separately and there was no consultation until both were concluded. Most patients were seen more than once by each observer, and some attended subsequently for gynaecological or psychiatric care. Observations made at these later attendances were used to confirm or refute the diagnostic impressions of the first interview. In our view, the series as a whole may reasonably be regarded as representative of the "out-patient population" of this clinic.