Diabetic Clinics and the General Practitioner

Diabetes, risk management, and the birth of modern primary care

“…9 In general, therefore, patients with diabetes were the perfect candidates for referral, and a significant proportion of GPs passed all diabetes care on to specialists. 10 Financial factors in referral were buttressed by intra-professional aversions and anxieties. On a local level, consultant staff and GPs could maintain good relations, but the existence of private medicine often helped to facilitate friendly co-operation.…”

“…GPs may have been responsible for initial disease detection, but, following referral, clinics often assumed the lead in diabetes care, and patients contacted community care staff for more quotidian issues, such as daily drug administration or treatment of unrelated illness. 23 In fact, reflecting on her contact with GPs over twenty years between 1960 and 1980, one patient recalled that 'apart from perhaps mentioning it [her diabetes] if I went to him with any other problem, it never seemed to be brought forward at all' . 24 It was a common arrangement, and not just for diabetes.…”