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The recent proposals/debate addressing the increasing genitourinary medicine (GUM) workload1 are imaginative. I wish to contribute the following observations.
The listed “guiding principles” for the GUM services role are missing the most important function that is expected by patients: to exclude sexually transmitted infections. Casual sex, contact tracing, and sexual assault are examples of conditions that require full assessment.
The revelation that some 9% of the sexually active population are harbouring asymptomatic chlamydial2 infection presents GUM physicians with a professional responsibility. Chlamydia screening will require extensive resources from primary care.3
The debate ignores the issue of funding. To assume that GPs are going to provide “additional services” for a lower cost than GUM clinics, with …