Acute chest and abdominal pain

Both in your busy group general practice and during the shifts you also do as a general practitioner in the local emergency department, you have the impression that patients are not only getting older but many of them are becoming more complex medically.

Urgent hospital attendance advised

During one of your regular Monday morning shifts in the emergency department you attend a patient with chest pain who has been allocated a triage category of 1 (to be seen immediately). The patient was expected as his wife had telephoned. You had overheard the surprisingly common conversation where it was made clear to the wife that she and her husband should call an ambulance and come in immediately. They, however, had decided to pack a bag and drive themselves in, arriving over an hour after the phone call and advice.