Equalitarian and Hierarchal Patients: an Investigation among Hadassah Hospital Patients

staff and general practitioners can hold meetings and gather socially. All these arrangements are being introduced in different areas, but is anyone studying their effect on the number and type of referrals to hospital, on general practitioners' use of diagnostic facilities, on waiting lists, or on the delays before general practitioners are notified of their patients' death or discharge? Similarly, it is not possible, just by studying the existing situation, to ascertain the effect on doctors' scope of work, efficiency and satisfaction, of working in purpose-built, well-equipped premises with adequate ancillary help. Obviously, doctors who spend money on these facilities under present-day conditions differ in many other ways from those who do not, so a comparison of the two groups cannot reflect what changes would result if improved conditions were either provided or encouraged by some different method of payment. Once again it should be possible to set up some sort of experiment which would provide information about this. A rather disquieting finding of this study was the lack of liaison between many general practitioners and health visitors. Some studies are already planned of health visitor attachments to general practice, and here, too, it is important that some sort of evaluation should be undertaken of the effect of such schemes.