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Issues at the interface between primary and secondary care in the management of common respiratory disease
    1. W F Holmesa,
    2. John Macfarlaneb
    1. aSherrington Park Medical Practice, Mansfield Road, Nottingham NG5 2EJ, UK, bRespiratory Infection Unit, Nottingham City Hospital, Nottingham NG5 1PB, UK
    1. Dr W F Holmes.

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    This commentary introduces a new series forThorax which, over the next six issues, will consider some of the common ground between respiratory physicians and primary care physicians (general practitioners (GPs) in the United Kingdom). Respiratory illnesses are among the most common reason for consultations in general practice and for acute hospital admissions, and much of the follow up of important respiratory disease is provided by general practitioners.

    General practitioners often complain, and not without some justification, that partnership with secondary care may be a euphemism for inappropriate, poorly communicated, and inadequately resourced transfer of responsibility at hospital discharge, or a means of using them to collect research data for their hospital colleagues. Respiratory physicians, however, can be proud of their record of collaboration with general practitioners. In the management of asthma in particular, primary care has been actively involved in a new understanding of the pathogenesis of asthma and, by working together, respiratory physicians, general practitioners, and nurses have achieved a fundamental change in the management of a …

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