B Künzi | PubMed Health

PubMed1993

[Is there a typical general practitioner?].

A random sample of 300 unbiased consultations on the premises of six Swiss general practitioners was analysed. In this article the results of the 'hard facts' (from patient questionnaires and the physicians tape-recorded consultation's essentials) are referred. The consultation length (average 16.5 min.) was underestimated by doctor and patient in 64% and 41% respectively. 81% of the patients saw us as their 'family doctor'. This term, however, is badly defined. Previous visits at home had taken place in 26 to 54% of all cases. Full patient satisfaction with the consultation was found in 80 to 90%, and the patients attested an optimal emotional approach. Also the financial aspects are mentioned. The authors are impressed by the finding of significant inter-doctor differences of important physician's practice patterns.

Adult↗

PubMed1993

[Do we use the potential of the general medicine consultation?].

Is there any congruence between vocational training as general practitioner and the needs of patients in primary care in Switzerland? What are the respective needs in the next century? These questions are discussed, based on the personal experience of the author after having completed his vocational training as general practitioner, on three years of experience as research fellow in a descriptive, cross-sectional and observational study of 300 consultations on the premises of six general practitioner-investigators and on a review of key research literature. Controversial views on the potential and the gaps in today's primary care are shown, focused on definition, training and research in the field of general or family practice. Of a broad range of experiences, two are pointed out: significant interindividual differences in practice patterns in primary care and emerging differences between primary care and teaching hospital medicine. The exceptional potential of primary care consultations has much to contribute to needed reforms in medical education and the health care system for the 21st century. Primary-care-based research and training will develop improved skills e.g. in communication, medical decision-making and patient management. Primary care is a discipline which includes insecurity and individuality; therefore, open questions and constant changes will be part of present and future for us and our patients.

Family Practice↗