Dr Richardson’s excellent editorial on the GP’s dilemma, Pressed to test: How should GPs respond? [BCMJ 2013;55:312] and Dr Cunningham’s explorations on declining professionalism [Exploring professional relationships in medicine, BCMJ 2013;55:314] should awaken us to the urgent need to modernize our health care delivery system. The cost to society of unnecessary medical investigation is an outrage. Much of what now passes for health care is very expensive reassurance.
No individual practitioner is accountable for the cost he or she engenders or for the quality of care he or she delivers barring disastrous outcomes. Medical care is too important and too expensive to be left to the whim of individual practitioners. Our present system rewards the mercenary unprofessional practitioner.
Imagine a system where teams of physicians with differing skills, working collegially, provide one-stop shopping for most patient complaints. Inexpensive electronic consultation could be used for many specialty consults. Group practice of this sort would help to restore professionalism and at the same time provide oversight for quality of care. Most importantly it would help us restore pride in our profession. Working together as a team to provide high-quality, cost-effective care would be more satisfying than working under our present piecemeal system with its archaic fee schedule.
If we as a profession can’t modernize our delivery system, the rampant rise in costs will force the government to do it for us.
—John Walton, MD
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