Support Services for Physicians
in General Practice
At one time family practitioners used to perform their own diagnostic tests and mix their own drugs but now they are dependent on external support services. As well in the past, most family doctors were prepared to work around the clock. Now most provide a telephone answering service after office hours and, as a result, some patients prefer to look for help from other sources. We shall now review these support services and their organization.
In recent years there has been extensive development of diagnostic services — laboratories and radiological services — which enable general practitioners to decide whether they can treat cases themselves or may need to seek further advice. The growing intensity of the use of diagnostic services and their increasing costs cannot be ignored (e.g., Elston 1987).
Laboratory development policies differ from province to province. The first well-developed laboratories were part of the government funded public health services concerned with controlling infectious disease. Then with the state funding of hospital insurance and the development of hospitals, most diagnostic tests for other conditions began to be carried out in hospitals. Community-based for-profit laboratories did a minor business until Medical Care Insurance provided for their doctors' fees to be paid by governments.
Most provincial governments have a laboratory advisory committee to help them to make decisions about the proportion of research funding versus service funding and how to balance profit and non-profit services (Crichton, Hsu and Tsang  1994). Some provinces have been more