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Results for “GENERAL PRACTICE”

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PubMed2000

List patient system: straitjacket or a tool for developing general practice? General practitioners' experiences from a pilot project in Norway.

OBJECTIVE: To investigate attitudes and experiences among general practitioners (GPs) taking part in an experiment with a list patient system in four municipalities in Norway. DESIGN: A questionnaire distributed to all 160 GPs in the four municipalities after 3 years' trial of the system. SETTING: Primary health care in Norway. MAIN OUTCOME MEASURES: The opinions of physicians on a list patient system after 3 years of trial. RESULTS: Most of the physicians held that the list patient system imposed more obligations than they were used to. However, the majority also held that the system enhanced preconditions for doing a good professional job; 68% wanted the system on a permanent basis, while 14% rejected it. CONCLUSION: Positive aspects outweigh negative aspects in the attitude of GPs to a list patient system.

Attitude of Health Personnel↗
PubMed2002

Single cases in general practice and general medical journals.

OBJECTIVE: To compare single cases published in general practice and general medical journals. METHODS: A systematic review of single cases in nine general practice and four general medical journals and a qualitative investigator triangulation for content. RESULTS: Just over seven percent of 10,607 publications involved single cases in both journal groups. Single cases were mainly published as reports or reviews in general practice journals and letters in general medical journals. Two percent of single cases were published as original research papers in general medical journals and none in general practice journals. No journal was prescriptive on the data elements required of a case write-up and few provided guidelines as to consent needs. Patient gender was reported in 97%, age in 85%, occupation in 17%, ethnicity in 10%, and consent in 5% of cases. Twelve percent of authors were general practitioners and 72% were specialists. Authors in general practice journals knew their cases longer compared with those in general medicine journals. General practitioners published over a wide range of case types including diagnostic error and relationship cases. In contrast, specialists published mainly on harm or unusual case types, but none on relationships. CONCLUSION: Single cases are common in the medical literature. The reporting of data elements (particularly consent) needs improvement. Comparatively few GPs publish single cases.

Authorship↗
PubMed1989

[A group-based training program. A model for general practice?].

General practice is fully recognized speciality in Norway, and the education is based on a five year programme of training. Part of the training takes place in groups with case meetings and tutorials. Practical skills are not a mandatory part of the programme, but a check list is introduced in order to give each trainee an opportunity to identify his/her level of experience. The article discusses several problems concerning teaching and learning practical procedures in general practice. Two models are presented whereby the trainees can learn procedures from each other.

Education, Medical, Continuing↗
PubMed2000

Cost-effective prescribing of proton pump inhibitor therapy: an audit in general practice.

General practitioners must prescribe cost effectively to control drug expenditure and provide optimal treatment for patients requiring long-term management. An audit was implemented in general practices to review the management of dyspepsia, improve care, rationalise therapy and reduce costs. Policy included identifying patients receiving proton pump inhibitor (PPI) therapy and changing to low-dose cost-effective therapy. If PPI therapy was not required, patients were changed to antacids, H2 receptor antagonists or no treatment. This was an audit in general practice, not a clinical trial, therefore findings reflect outcomes in normal clinical practice. This paper describes the implementation and findings of the audit between January 1997 and July 1999 in 91 general practices involving 7121 patients. Extrapolation of the results concluded that savings of up to 50,000 Pounds could be made in a practice of 10,000 patients, allowing reinvestment in health improvement plans and optimal care.

Adolescent↗
PubMed2002

Attitude of medical students towards general practice and general practitioners.

BACKGROUND: The stimuli for this work came from the need to identify and understand the origin of students' attitudes towards general practice in the context of undergraduate curriculum reform and concerns about recruitment. AIM: To evaluate attitudes of medical students towards general practice as a specialty and general practitioners (GPs) as doctors and explore factors influencing students' attitudes and intended career choice. DESIGN OF STUDY: Cross-sectional survey. SETTING: Final-year students at two London medical schools. METHOD: Questionnaires were distributed to 984 students and the results analysed using SPSS analysis. RESULTS: The mean response rate was 72% (700/984). Medical students had a positive attitude towards general practice as a specialty (mean Likert score = 3.90/5, 95% confidence interval [CI] = 3.86 to 3.94) and towards GPs as doctors (mean Likert score = 3.62/5, 95% CI = 3.59 to 3.66). They rated personal experience of GPs as the most important factor influencing their attitude. Students' attitudes towards general practice and GPs were more positive (P<0.001) in the fifth year. First-year students perceived the media to have a more important role in influencing their attitude than those in the fifth year(P<0.001). General practice was the only career option to significantly increase in popularity between the first and final year(P < 0.001). CONCLUSIONS: Medical students end their undergraduate years with a more positive attitude towards general practice than has been reported elsewhere recently. This may be partially explained by the greater contact with GPs and suggests that efforts by medical schools to ensure a more balanced, community-based curriculum promotes positive attitudes to general practice. The influence of the media on the first years of medical school requiresfurther investigation.

Attitude of Health Personnel↗
PubMed1994

Metamorphoses in medicine. A view from general practice.

General practice once involved the work of all the specialties, particularly in the sparsely populated areas of Australia's north and west. Now the specialists are more likely to be available for referral, but general practice has evolved into a specialty of its own.

Anesthesiology↗
PubMed1990

Role of hypnotic drugs in general practice.

General practice physicians commonly deal with patients who report experiencing insomnia. Advances in our understanding of insomnia should result in much more effective diagnosis and therapeutic intervention for insomnia patients at the primary care level. This presentation highlights the new knowledge of insomnia pertinent to general practice physicians and discusses the rational use of hypnotic medications in primary care.

Anti-Anxiety Agents↗
PubMed2001

Ways of using evidence-based medicine in general practice.

General practitioners wanting to practise evidence-based medicine (EBM) are constrained by time factors and the great diversity of clinical problems they deal with. They need experience in knowing what questions to ask, in locating and evaluating the evidence, and in applying it. Conventional searching for the best evidence can be achieved in daily general practice. Sometimes the search can be performed during the consultation, but more often it can be done later and the patient can return for the "result". Case-based journal clubs provide a supportive environment for GPs to work together to find the best evidence at regular meetings. An evidence-based literature search service is being piloted to enhance decision-making for individual patients. A central facility provides the search and interprets the evidence in relation to individual cases. A request form and a "results" format make the service akin to pathology testing or imaging. Using EBM in general practice appears feasible. Major difficulties still exist before it can be practised by all GPs, but it has the potential to change the way doctors update their knowledge.

Australia↗
PubMed2000

[Effectiveness and efficiency of ambulatory diabetes education programs. A comparison of specialty practice and general practice].

BACKGROUND AND OBJECTIVE: The increasing incidence of NIDDM requires adequate proof of the effectiveness and efficiency of out-patient programmes for diabetics. This study aimed at examining which of the two methods may promise the better results under controlled expenses--modifications of the present standardized diabetes education program in the general practice or specifically developed diabetes education programme in specialist diabetes practice. PATIENTS AND METHODS: 75 diabetics took part in the different out-patient diabetes education programmes at one special practice for diabetology or one of seven general practitioner practices, respectively. The self-developed intensive diabetes education programme of the special practice led by two specialists in diabetology and a dietician was compared with the diabetes education programme of the general practices performed by a doctor's assistant. 38 diabetics in eight training groups at the specialist for diabetology and 37 patients in seven training groups at the general practices were instructed. 32 patients in total (18 patients at the specialist practice and 14 patients at the general practices) additionally received an evaluated support programme which addressed psychosocial impediments related to the topics of a structured diabetes therapy. All patients were asked to complete a questionnaire before, right after, 3 and 6 months after the programme. Weight and glycosylated haemoglobin (HbA1c) were measured before, 3 and 6 months after the programme. RESULTS: The mean weight and glycosylated hemoglobin of all groups decreased as expected. However, the patients of the general practices achieved more lasting reduction of these objective parameters. All patients stated impairments of their quality of life, but the patients of the specialist practice felt more impaired. The motivational support programme achieved only few positive results. CONCLUSION: The standardized diabetes education programme of the general practices and the more intensive and expensive diabetes education programme achieved equally valuable results. Regarding time and expenses, the standardized diabetes education programme may be the more efficient method of NIDDM out-patient education.

Aged↗