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At least 163 records · Page 9Linked to original sources
PubMed1988

Comparison of the work of a nurse practitioner with that of a general practitioner.

The work of a nurse practitioner was compared with that of a general practitioner. Both were equally available to the same patient population over the same period. The nurse practitioner saw a similar age and sex distribution of patients to the doctor but saw different types of problems. More of the patients she saw were for followup of chronic diseases, health advice and screening measures while fewer were acutely ill. The doctor dealt with four times as many patients. The nurse practitioner managed 78% of her consultations without referral to a doctor, and 89% without resorting to prescribed drugs. There was a high level of patient satisfaction with her work and 97% of the patients who saw the nurse would choose to consult her again. The role of the nurse practitioner in our practice has developed differently from a similar post in another setting, thus emphasizing the need for flexibility when defining the role.Nurse practitioners are a valuable extra resource for the development of new areas of care, rather than a cheaper substitute for a general practitioner.

Adolescent↗
PubMed2001

[General practitioners' knowledge of and attitude to assessment and treatment of women with urinary incontinence. A questionnaire among general practitioners in Denmark].

INTRODUCTION: Urinary incontinence is a common problem for adult women, and the need for assessment and treatment of incontinence is expected to increase in the future. The aim of this study was to elucidate the general practitioners' (GPs) knowledge about and attitude to women with urinary incontinence. METHODS: A questionnaire was posted to 1700 randomly selected GPs in 1998 and 1999. RESULTS: A total of 1071 (63%) GPs responded at least once. Five hundred (29%) returned the questionnaire both years. About 50% expressed a positive interest in the management of urinary incontinence. Only 24% felt that their knowledge was sufficient to manage incontinence. About 50% and 66% of the GPs would probably refer a patient with stress incontinence or urge incontinence to a specialist. The GPs' proposals for assessment and treatment were mainly consistent with good clinical practice. There were only minor changes in knowledge and attitude from 1998 to 1999. DISCUSSION: GPs' interest in urinary incontinence is moderate and management is characterised by a high referral rate to a specialist. Most GPs. consider their knowledge to be inadequate. There is need for education to ensure sufficient knowledge and to change the attitude, so that first-line assessment and treatment of urinary incontinence is carried out in general practice.

Adult↗
PubMed2004

[The practice guideline 'Pregnancy and puerperium' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice medicine].

The first revision of the Dutch College of General Practitioners' practice guideline about pregnancy and puerperium does not significantly differ from the first edition. The guideline is extensive, is well-worth reading and supports daily practice. There is a greater emphasis on the importance of cooperation and differentiation in primary care (midwifes and general practitioners). During the last decade many general practitioners stopped doing home deliveries and have therefore lost their experience in obstetric care and pathology. The guideline describes the general practitioner's tasks as a preconception counsellor, a professional expert on illnesses during pregnancy and after the delivery, and as the doctor of the newborn baby. It will hopefully stimulate a revived interest of and involvement in pregnancy and post-partum care among general practitioners.

Family Practice↗
PubMed1988

The general practitioner and the family. A study of the use of general practitioners' services by families with children.

The extent of the GP's contact with families with children, and the influence of family characteristics upon the utilization of health care have been registered. Seventy-one families in a rural district in Norway were followed for two and a half years. On average, the GP had approximately one contact per month with one member of each family. Demographic family data, such as age or number of children, were not found to be of great significance for the number of contacts. Children's encounters with the GPs correlated with those of the mothers, but not with those of the fathers. The most important factors influencing the families' use of health services were the prevalence of chronic illness, psychological stability in parents, and the occurrence of changes in family composition. The gains from approaching the family as a unit are discussed.

Adolescent↗
PubMed1997

Communication about risk--dilemmas for general practitioners. The Department of General Practice Working Group, University of Wales College of Medicine.

Measures of risk frequently contribute to our understanding, prevention, or treatment of disease, but it is important that general practitioners (GPs) explain clinical risks effectively to patients to ensure they are not misunderstood, as risk information can assist in decision-making processes and encourage behavioural change. However, the interpretation of risks by patients and doctors varies. It is argued that problems arise because communication about risk is usually framed in terms of the language of chance or probability. In this paper, we describe how probability theory developed, and suggest that attempts to communicate empirical risk processes in probabilistic language are bound to produce dilemmas. We explore how the theory relates to clinical practice and identify key issues that doctors must address in discussing risk with individual patients.

Communication↗
PubMed1991

[Study and treatment of urinary incontinence in women. A case load based study by general practitioners and gynecologists].

139 general practitioners and 190 gynaecologists responded to a case-history questionnaire about female urinary incontinence. More gynaecologists than general practitioners reported more frequent use of leakage provocation test, neurological examination, frequency-volume chart, and measurement of residual urine. Among the less relevant procedures, use of blood tests was reported more frequently by general practitioners, and use of x-rays and ultrasonography by gynaecologists. General practitioners preferred urine microscopy to urine culture. The opposite was true for the gynaecologists. 50% of the gynaecologists would prescribe oestrogens for the postmenopausal women, as against 25% of the general practitioners. Young women were instructed in pelvic floor exercises, incontinence pads were prescribed for elderly women.

Adult↗
PubMed1983

Patient education in general practice: opinions of general practitioners.

Fifty-two general practitioners were interviewed regarding their task in patient education and various aspects of it. The view general practitioners have on patient education is complex. Although they consider it a central task, the range of methods they are willing to use is limited. Many general practitioners tend to overlook the fact that they are not the only source of information and explanation for patients. They would prefer to keep control over information given patients, fearing that patients might be confused. It is notable that many general practitioners have no clear standards of what patients need to know. Much depends on the questions the individual patient asks. There are several kinds of information that general practitioners are disinclined to give, particularly relating to uncertainties or information that might alarm the patient. The outlook for improvement must not be overestimated. Some directions are given for supporting the development of patient education.

Attitude of Health Personnel↗
PubMed1972

General-practitioner ward in a district general hospital.

A general-practitioner ward, made available at the local hospital, was used by 34 of 64 local practitioners offered contracts by the regional board. Four of the five doctors in our practice took up contracts, and we were responsible for 119 admissions (100 patients) in one year. Had the general-practitioner ward not been available 73 hospital admissions would have been needed; in 27 cases care at home would have been the alternative, while the remaining 19 patients could have been seen as outpatients. Only seven consultant opinions were sought during the year.

Adolescent↗
PubMed2004

[The practice guideline 'Peripheral vascular disease' (first revision) from the Dutch College of General Practitioners: a response from the perspective of general practice].

The practice guideline 'Peripheral vascular disease' (PVD) from the Dutch College of General Practitioners will certainly be of benefit to the Dutch general practitioner. Its limited set of simple diagnostic steps can help the general practitioner to assess or exclude PVD in patients with intermittent claudication. The inclusion of a pretest-posttest probability scheme enhances a clear diagnostic process. This guideline differs from the previous one in one important aspect. This guideline deals not only with the specific management of peripheral arterial disease but also with the management of cardiovascular risk in general. In this way the guideline follows the recently changed international attitude reflected in the European Guidelines on cardiovascular disease prevention. Smoking cessation and exercise therapy continues to be the cornerstone as well as the stumbling block of management of most cases of PVD in general practice; a challenge for every general practitioner.

Exercise Therapy↗
PubMed1990

[Physicians' contact with the drug industry. An interview among general practitioners].

Seventy-eight general practitioners were interviewed by questionnaire on the subject of contact between general practitioners and the pharmaceutical industry. There seemed to be a certain discrepancy between the existing working instructions of the pharmaceutical industry and the needs of the general practitioners. Nevertheless, the overall contact seemed to be satisfactory. Most general practitioners wished to be visited by representatives of the pharmaceutical industry, preferably qualified ones. The opinions of male and female doctors were generally the same.

Consultants↗
PubMed1996

[Paroxysmal anxiety crisis, viewpoint of the general practitioner].

According to general practitioners, anxiety disorders are amongst the commonest complaints in primary care. A survey carried out by réseau Sentinelle in June 1995 showed that acute panic attacks in general practice have given rise to 300,000 hours of consultations per year by general practitioners in France. Positive diagnosis raises practical difficulties in the surgery or at home, GPs could avoid such difficulties by using diagnosis criteria based on DSM IV and having knowledge of the patient's anticipation anxiety. In order to make the differential diagnosis, GPs will need to rule out any organic cause, notably cardiovascular pathology. Prior acquaintance with the patient will be of great help. A decision to treat is based on the frequency of acute panic attacks and on exchange of information with the psychiatrist. In return, the specialist will assist the GP in managing the patient's condition.

Anxiety Disorders↗
PubMed1987

District programme to reduce smoking: effect of clinic supported brief intervention by general practitioners.

By encouraging and supporting general practitioners to undertake brief intervention on a routine basis smokers' clinics could reach many more smokers than are willing to attend for intensive treatment. In a study with 101 general practitioners from 27 practices 4445 cigarette smokers received brief intervention with the support of a smokers' clinic, brief intervention without such support, or the general practitioners' usual care. At one year follow up the numbers of smokers who reported that they were no longer smoking cigarettes were 51 (13%), 63 (9%), and 263 (8%), respectively (p less than 0.005). After an adjustment was made for those cases not validated by urine cotinine concentrations the respective success rates were 8%, 5%, and 5%. Use of nicotine chewing gum was associated with higher self reported success rates. General practitioners providing supported brief intervention encouraged not only more smokers to use the gum but also more effective use; gum users in this group reported a success rate of 27% at one year. Compliance by the general practitioners in recording smoking state averaged 45%, and significantly higher success rates were reported by patients whose smoking state had been recorded. Brief intervention by general practitioners with the support of a smokers' clinic thus significantly enhanced success rates based on self reports. Better results might be obtained if general practitioners' compliance with the procedure could be improved and if they encouraged more of their patients to try nicotine gum. Collaboration of this kind between a smokers' clinic and local general practitioners could deliver effective help to many more smokers than are likely to be affected if the two continue to work separately.

Adult↗