Analysis of patients referred to the gastroenterology service of a VA medical center.
We recorded clinical information over a 12-month period on consecutive consultations to the gastroenterology service of the Durham VA Medical Center. Of 902 consultations, 789 were prospectively collected. Eighty-five percent of the patients were between 40 and 70 years old. Seventy-five percent of the referrals were from the internal medicine service. The most frequent reasons for consultation were abdominal pain (19%), GI bleeding (active, 16%; occult, 9%), abnormal results of liver tests (18%), and request for a procedure (11%). Diseases of the liver (32%) and "peptic diseases" (30%) were the most common diagnoses. One or more procedures were done in 71% of consultations. When these data are compared with those of a practicing gastroenterologist, using an identical instrument, it is apparent that trainees' experience with structurally identifiable gastroenterologic disease and with a variety of procedures was similar in scope. There were, however, differences in that the physicians at the VA saw substantially fewer patients with so-called "functional" illness. If these data are applicable to other VA Medical Centers, then the training of physicians in gastroenterology at a VA Medical Center should probably be broadened.
D000328:Adult; D000368:Aged; D005260:Female; D005762:Gastroenterology / Q000193:education*; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D006787:Hospitals, Veterans; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D012017:Referral and Consultation