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Biomedical subjects

A N Thomson

Publications and source records attributed to A N Thomson.

33 records · Page 2Linked to original sources
PubMed1990

An assessment of a postgraduate examination of competence in general practice: Part 2: Validity.

The 1987 part one examination of the Royal New Zealand College of General Practitioners was evaluated. This assessment of competence assumes that the results of the assessment truly reflect the competence of the candidate in real life. The degree to which the assessment achieves this is a measure of its fairness and accuracy. This report discusses the methodology and results of the evaluation of the validity of the part one examination.

Certification↗
PubMed1990

An assessment of a postgraduate examination of competence in general practice: Part 1--Reliability.

The 1987 part one examination of the Royal New Zealand College of General Practitioners was subjected to an evaluation. The format of the examination and the scope of the review is described. This paper describes the assessment of the reliability of components of the examination. Simulations showed acceptable reliability, however the reliability of the written paper was less satisfactory. The ways in which such reliability may be enhanced are described.

Clinical Competence↗
PubMed1989

What future for solo general practice?

Marketing theory predicts that solo general practitioners are disadvantaged financially when compared to doctors practising in groups. This is supported by a 1985 random survey of Auckland general practitioners. This shows solo practitioners to have had a significantly lower net and gross income than did group practitioners in the time period 1981-82 to 1984-85. The difference is due to the combined effect of solo practitioners charging marginally lower fees, and seeing less patients weekly than did group practitioners. These results are discussed from a marketing perspective.

Family Practice↗
PubMed1989

Prepaid health care in general practice: acceptability and effect on utilisation.

A prepaid child health scheme was offered to the patients of a rural practice in January 1988. The acceptability of the scheme was monitored in terms of entry and exit rates. The effectiveness of the scheme was measured in terms of its effect on the rates of consultation for acute illness and prevention, and the cost of the scheme to the practice and to patients was assessed. The scheme reduced the annual cost of general practice services for those children enrolled in the scheme by $73.68. There was no evidence that the scheme improved access for the low users of child health care. The scheme was a financial loss for the practice.

Adolescent↗
PubMed1989

Oral acyclovir in the treatment of herpes zoster in general practice.

A double-blind, randomised trial evaluated the efficacy of oral acyclovir, 800 mg 5 times daily for 7 days, in acute herpes zoster and postherpetic neuralgia. Forty patients aged 16 years or over, presenting to their general practitioners within 3 days of rash onset, received acyclovir, while 43 patients received placebo. Acyclovir reduced the extent and duration of the rash, the spread of the rash to adjacent dermatomes and the incidence of disseminated lesions. It shortened the period of new lesion formation and reduced the incidence of ulceration. The weekly prevalence of pain was reduced on acyclovir by the fourth week, with a reduction in the monthly prevalence of chronic pain in the second and third months and a reduction in associated local neurological symptoms between months 3-6. Total analgesic use in the first 4 weeks was reduced by acyclovir, but during follow up there was no difference in the prevalence of analgesic use between groups. There were slightly fewer medical events on acyclovir in the second week, but the frequency was the same in each group for the rest of the 6 months. Biochemical and haematological tests showed no adverse effects of treatment.

Acute Disease↗
PubMed1989

The variability of general practitioners' fees.

A random sample of the general practitioners in the Auckland urban area was surveyed in 1985. Data on fee levels, costs and workload was collected. Analysis of this data shows the variability of doctors' fees is not easily explained in terms of indicators of quality of practice, workload, practice structure or the location of the practice.

Family Practice↗
PubMed1988

Does the computerisation of a general practice increase doctor's fees?

While few Auckland general practitioners had inpractice computers before 1981-2, many installed computers after 1981-2. In order to assess some of the determinants of the computerisation of practices and the outcomes of computerisation, data was collected on a random sample of Auckland urban area general practitioners for the financial years 1981-2 and 1984-5. The characteristics of those installing computers and the effect of computerisation on practice costs, fees and workloads was explored. No significant difference in fees was seen between computerised and noncomputerised general practitioners, but differences were observed in practice costs and practice workstyles. The cost of the purchase of a computer by a practice does not appear to be directly passed on to the consumer in higher patient fees.

Costs and Cost Analysis↗
PubMed1988

Workloads in Auckland general practice 1981/82 to 1984/85.

A random sample of Auckland general practitioners was surveyed in 1985. Data describing their workload, practice style and practice finances for the years 1981/82 and 1984/85 was collected and analysed. The trends in general practice during this time were studied, and the results compared to national data from various sources and to data from the Department of Health for the years 1984/85 and 1986/87. The workload of practitioners has appeared to remain static despite decreasing patient: doctor ratios. The real income of general practitioners is falling.

Data Collection↗
PubMedDate not supplied

Management options for elderly ill patients who present in the weekend.

An informal impression that there was a shortage of facilities for elderly patients who presented, with a routine illness, to a weekend duty doctor was studied by interviewing duty doctors and providers. The duty doctors stated that the major problems were the deficit in support from friends, relatives and neighbours and the lack of remuneration for the duty doctors. The doctors said that the main supports, paradoxically were friends, relatives and neighbours, and the acute medical ward. The recommended facilities included an urgent district nurse and a short-stay, assessment unit. Among providers only the medical ward and the private laboratories were willingly offering more than a minimal service.

Aged↗
PubMedDate not supplied

How do general practitioners manage rectal bleeding?

OBJECTIVE: To determine how general practitioners (GPs) in northern Tasmania manage rectal bleeding in terms of examination, referral, and patient investigation and estimate the value of early diagnosis of colorectal cancer (CRC). METHOD: Self reported postal questionnaire survey sent to 100 randomly selected GPs in northern Tasmania. RESULTS: Sixty-eight per cent of GPs responded. The clinical action proposed by GPs varied considerably according to patient age and type of rectal bleeding. The proportion of GPs who would refer a patient to a specialist varied from 15 to 100% depending on the specific scenario. Responses were not consistent with the available consensus guidelines and evidence. Most GPs believed that early diagnosis of CRC through screening and the early detection of rectal bleeding improved outcomes. However, fewer than half the respondents believed that there were clear guidelines about the management of a patient with rectal bleeding, emphasising the need for evidence-based guidelines which are effectively disseminated and clinically evaluated. Rural GPs indicated that distance from specialist investigation and referral centres would influence patient management. CONCLUSIONS: There is a wide variation in the way GPs manage rectal bleeding and inconsistent knowledge about the existence of guidelines for managing rectal bleeding. Evidence-based education about the management of this common clinical problem, which is effectively disseminated and clinically evaluated, would seem appropriate.

Adult↗