PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “General Practice”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed2003

"Only a GP?": is the solution to the general practice crisis intellectual?

General practice is suffering a crisis of status, as shown by financial, power and intellectual markers. This is serious as a strong general-practice workforce is important to deliver cost-effective, high-quality healthcare. We argue that strengthening the intellectual aspects of general practice (particularly critical thinking) is essential. Most strategies to achieve this centre on research, with many initiatives in Australia and overseas to enhance research by general practitioners; there is still insufficient clinical research in general practice. Other ways to improve critical thinking include promoting use of evidence-based medicine, provided it is not implemented only via "cook-book" guidelines. Other innovations are desperately needed.

Attitude of Health Personnel↗
PubMed1967

General practice.

Explore the source record for details and available documents.

General Practice, Dental↗
PubMed1992

Lithium treatment: prescribing and monitoring habits in hospital and general practice.

OBJECTIVES: To define current clinical practice of lithium prescribing and monitoring and to compare hospital based practice with general practice. DESIGN: Prospective study of doctors' practice. SETTING: Psychiatric hospital day and outpatient facilities and general practices in Edinburgh and Midlothian district (population 600,000). SUBJECTS: 458 patients taking lithium who had been stabilised and who remained as outpatients during the year of study. 219 were treated by their general practitioner and 190 by the hospital; 49 had shared care or care transferred during the study. MAIN OUTCOME MEASURES: Daily dose, duration of treatment, psychiatric diagnosis, mean annual serum lithium concentration, frequency of occurrence of and response to raised serum concentrations. RESULTS: Compared with hospital doctors general practitioners were more likely to prescribe lithium three or more times daily (43/219 (general practice) v 10/190 (hospital); chi 2 = 18.6, p = 0.001) and to estimate serum concentrations less frequently (4.5 v 5.3 measurements/year; t = 3.04, p = 0.003), and their patients were more likely to experience raised lithium concentrations (39/219 v 17/190; chi 2 = 6.8, p = 0.01). One third of doctors made no response to raised lithium concentrations in the next six weeks. CONCLUSIONS: General practitioners and hospital doctors care for similar types of patients and the stringency of lithium surveillance varies greatly among doctors. Certain aspects of practice give cause for concern and could be improved by following more uniform guidelines.

Adolescent↗
PubMedDate not supplied

Practice nurses--working smarter in general practice.

BACKGROUND: Recent government funding initiatives have increased the number of nurses in general practice and the range of tasks undertaken by them. These nurses are trained, professionally regulated health care professionals who can make a significant contribution to the work of the practice. OBJECTIVE: Approaches are described that enhance available general practice services, allow for the nurse to substitute for the general practitioner in some tasks, and leads to a delegation of roles that can improve patient health outcomes. DISCUSSION: A well educated, well supported practice nurse can enhance both the services provided by a general practice and the income derived from such services.

Australia↗
PubMed2005

A technical infrastructure to conduct randomized database studies facilitated by a general practice research database.

General practice research databases are increasingly used to study intended and unintended effects of treatments. However, confounding by indication remains a major problem. The randomized database study methodology has been proposed as a method to combine the strengths of observational database (generalizability) and the strength of the randomized clinical trial (RCT) design (randomization). We developed an infrastructure that enables the execution of randomized database studies with treatment randomization facilitated by a general practice research database. The requirements posed by the methodology of randomized database studies were facilitated by software components. Our assessment showed that it is technically possible to conduct randomized trials in general practice according to the randomized database design. The infrastructure facilitated the conduct of randomized database studies in general practice but some practical difficulties and methodological issues remain. The technical infrastructure seems to be both promising and potentially feasible to facilitate future randomized database studies, although the methodology needs to be evaluated in more detail.

Biomedical Research↗
PubMed1992

Practical medical education in general practice.

The Medical Faculty of the University of Limburg in Maastricht, The Netherlands pays special attention to extramural care. The extramural profile of the Medical Faculty also manifests itself in the curriculum. Since 1978, a 12-week clerkship in practical medical training in general practice (PMT-GP) has been offered to fifth-year students. The general aim is to acquaint students with general medical aspects as well as specific primary care aspects of health care. The programme started in the autumn of 1978 with 24 students and 24 GP teachers. At present more than 100 GP teachers, working in about 70 practices, train 120-130 students a year. The model of the PMT-GP system is characterized by six features: a ratio of one GP teacher to one student; autonomous examination by the student of at least 15 patients a week; daily follow-up discussion on the basis of patient records prepared by the student; opportunities for self-study by the student; one tutorial day a week at the Medical Faculty; intensive contacts between the Faculty and GP teachers. Key activities of the PMT-GP include autonomous contacts with patients, written records and daily follow-up discussions with the GP teacher.

Clinical Clerkship↗
PubMed1997

Chronic debilitating fatigue in Irish general practice: a survey of general practitioners' experience.

BACKGROUND: Doctors are called upon to treat chronic debilitating fatigue without the help of a protocol of care. AIMS: To estimate the incidence of chronic debilitating fatigue in Irish general practice, to obtain information on management strategy and outcome, to explore the attitudes of practitioners (GPs) towards the concept of a chronic fatigue syndrome (CFS), and to recruit practitioners to a prospective study of chronic fatigue in primary care. METHOD: A total of 200 names were selected from the database of the Irish College of General Practitioners (ICGP); 164 of these were eligible for the study. RESULTS: Altogether, 118 questionnaires were returned (72%). Ninety-two (78%) responders identified cases of chronic fatigue, giving an estimated 2.1 cases per practice and an incidence of 1 per 1000 population. All social classes were represented, with a male to female ratio of 1:2. Eleven disparate approaches to treatment were advocated. Many (38%) were dissatisfied with the quality of care delivered, and 45% seldom or hardly ever referred cases for specialist opinion. The majority (58%) accepted CFS as a distinct entity, 34% were undecided, and 8% rejected it. Forty-two (35%) GPs volunteered for a prospective study. CONCLUSION: Chronic fatigue is found in Irish general practice among patients of both sexes and all social classes. Doctors differ considerably in their management of patients and are dissatisfied with the quality of care they deliver. Many cases are not referred for specialist opinion. A prospective database is required to accurately assess the scale of this public health problem and to develop a protocol of care.

Adult↗
PubMed1996

Comparison of appropriateness of cholesterol testing in general practice with the recommendations of national guidelines: an audit of patient records in 20 general practices.

OBJECTIVE: To compare the profiles of those patients selected by general practitioners for measurement of serum cholesterol with the recommended profiles for opportunistic cholesterol testing described in the national practice guidelines published by the Dutch College of General Practitioners. DESIGN: Retrospective audit of general practitioners' records. MATERIALS: Practice records of 3577 adult patients systematically sampled from 20 general practices. MAIN MEASURES: With criteria set by the national guidelines, the proportion of patients per practice (a) for whom cholesterol testing would be considered justified, and (b) for whom cholesterol testing would be considered unjustified, and the proportion of patients within each of these groups who had had a cholesterol measurement recorded. RESULTS: Cholesterol tests were performed on 415 (11.7%) of the 3577 patients. National guidelines on the management of hypercholesterolaemia state that a positive cardiovascular risk profile is an indication for cholesterol measurement. Just under one fifth (668) of the patients in this study were recorded as having a positive cardiovascular risk profile, but only 31% of these had had their cholesterol measured. Of the patients without recorded evidence of a positive cardiovascular risk profile cholesterol had been measured in 8%. Restricting the analyses to the age group 18-65 (n = 3060) of whom 12.5% had a positive risk profile, did not improve the results. In practices with a computerised information system 37% of patients with recorded evidence of a positive cardiovascular risk profile had had their cholesterol measured. CONCLUSIONS: Cholesterol testing was not targeted as selectively as recommended by the national guidelines. The major problem was failure to test those likely to benefit. Improving the targeting of cholesterol measurements would undoubtedly increase the workload of general practitioners. If the national guidelines are to have an effect on health promotion the first step must be to increase the proportion of patients with positive cardiovascular risk profiles who get their cholesterol tested. A major factor in successfully selecting cases seems to be that practices are equipped with a computerised medical information system.

Adolescent↗
PubMed1990

The hidden agenda and diagnosis in general practice.

Diagnosis in general practice involves more than the diagnosis of a physical illness. An important objective of a general practice consultation is to understand the hidden feelings and fears of the patients. Seven case reports are presented to demonstrate the need to go beyond the physical diagnosis and to identify the hidden agenda in order to make a comprehensive biopsychosocial diagnosis of the patient's problems. A good bedside manner is more than good manners. It is an essential ingredient of the diagnostic process in general practice.

Adult↗
PubMed2006

[General practice research supervision].

INTRODUCTION: General practice is a subject with a relatively short scientific tradition. The purpose of this study was to elucidate who gives long-cycle general practice research supervision in Denmark, who is supervised and how research students get on. MATERIALS AND METHODS: All research students with research advisers in the field of general practice filled out a questionnaire in 1997 (n = 50) and 2003 (n = 52). There were questions about project/research training, professional education, advisers and the students' attitude to taking on advisory functions in the future. In 2003, 48 of those from the 1997 cohort also answered a follow-up questionnaire. RESULTS: The number of research students with a connection to the general practice research field was fairly constant from 1997 to 2003. The number of permanently employed general practice advisers, on the other hand, has doubled, and these now undertake more of the advisory functions. The great majority of research students complete their projects, most of them at PhD level. Most of the research students surveyed indicated that they are prepared to take on advisory functions when they have acquired the competence to do so. DISCUSSION: The general practice research students vary greatly with regard to age, interests and career paths, but almost all complete their research studies. This may be due to the flexible framework for research in general practice and the increase in recent years of advisory capacity in general practice. This positive development is expected to continue through the development of networks, course activities and continuing follow-up of the advisory functions.

Biomedical Research↗