The concerns of Drs Purkis [BCMJ 2001;43(2):71] and Toewes [BCMJ 2001;43(4):195] are certainly not exaggerated and I would not like to see them go unheeded. A little elaboration may be of help.
Urban general practice is now very rapidly coming to crisis stage. This may sound jaded in view of all the other daily cliches about “health care crisis” in the daily news, but it is now an absolute fact.
During the current year 2001, the number of family physician retirements in the New Westminster/Tri-Cities area has produced a critical number of orphaned patients. These unfortunate souls have been set loose, often with short notice by their ill, ageing, or burned-out physicians, and are frantically searching for a new family physician—in vain. There are no new physicians setting up in a traditional family practice. Why is this so? Here are some of the reasons:
• Brain drain.
• Practices are full.
• Retiring physicians can’t give away a practice—let alone sell it. As recently as 10 to 15 years ago a practice was a valuable asset, worth up to $100,000.
• No locums are available to spell us off. Of the very few locums available, many won’t assume full practice responsibility of on call and hospital duties. They are demanding a higher percentage of gross, and frequently demand a minimum guarantee.
• Even in a multi-practice physician’s office, because of full practices, it is difficult for the partners to cover the extra load.
• The locum pool is in full- or part-time practice in walk-in clinics—no stress, high volume, no on call, no difficult chronic illnesses, no nursing homes, no hospitals, minimal paperwork, no meetings in the hospitals.
Due to this, we can’t get time off.
We must make traditional family practice more attractive to the up and coming group of young physicians, as well as the incumbents. We must have a differential between us and the walk-in clinics. We have to get a premium for dealing with phone calls, on call, paper work, dealing with hospitals and nursing homes, and running an office. General practice needs to attract new physicians and retain the old.
—G. Kenefick, MB
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org