I concede that dementia subtyping is my role, not the role of medical colleagues. To sleuth out whether someone's got Alzheimer's disease and merits drug treatment, or has vascular dementia, Lewy Body dementia, or something obscure, sits firmly in Old Age Psychiatry. This I am happy with.
A local neurologist who I respect enormously (and has a brain the size of Saturn) also diagnoses dementia subtypes in her patch and does so incredibly well. Referrals from her are a joy. This too makes me happy.
Most of the GPs in my corner are very good indeed. They are committed, receptive to ideas, often doing what's best for their patients even if that does fall a touch outside protocols, guidelines and edits of What Thou Shalt Do. GPs with common sense, this makes me happy.
Although a diagnosis of dementia can be made by a GP or Consultant colleague, then referred on to me for dementia subtyping and appropriate treatment, some GPs aren't sure and refer patients who may or may not have dementia and don't make the diagnosis themselves. I'm fine with this, too. At best we're picking up dementia early, at worst I'm reassuring the GP and his patient that all is well. I don't have to be always treating and intervening. Supporting GPs in areas they're not sure about is, to my mind, a valid use of Consultant time.
It's good that local GPs can query concerns with me and express themselves frankly.
Still, there are some basics I would hope all clinicians have an appreciation of.
What surprised me in chatter with a local GP about our services was his honest question, "What's dementia?"