Same thing happens all over the world I'm afraid - when you qork in A&E you get the same crap referrals from disinterested GP's. I once had a patient referred on a busy Saturday afternoon with a trigger finger of all things. I examined the patient, confirmed the diagnosis and sent the patient back to the GP with a note saying basically "yes it's a trigger finger. Why not refer to the orthopaedic surgeons who can fix it?" As for the one that make up vital signs - don't get me started.