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General practice residency training program in Thailand: past, present, and future.

The General Practice was approved by the Thai Medical Council as a specialty in 1969. The residency training programs were revised in 1992. The first three - year rotating postgraduate residency training program was started in 1973 with a total of 9 programs by the late 1980s. Seven were in Bangkok, and the other 2 were in the North. The programs contained curricula objectives, clinical rotation in various disciplines including a general practice block in provincial or community hospitals. The weakness of the programs was the lack of a general practice department, a general practice trainer or preceptor and a general practice course organizer. Finally, the General Practitioners Association played a little role in the postgraduate general practice residency. After the revision, the general practice residency was changed to family medicine residency training in 1999. The College of Family Physicians of Thailand was established to take a central role in postgraduate education.

Certification↗

Patient presentation at medical practices with dental problems: an analysis of the 1996 General Practice Morbidity Database for Wales.

OBJECTIVE: To describe the characteristics of attendances and patients who present to family medical practitioners with oral or dental problems. DESIGN: Secondary analysis of standard consultation data. SETTING: 30 family medical practices in the General Practice Morbidity Database for Wales. SUBJECTS: All patients who presented at the practices with an oral or dental complaint during 1996. RESULTS: Of the 1,650,882 patient attendances at the 30 medical practices in the study year, 4,891 (0.3%) were for oral/dental problems. The frequency of these attendances varied considerably between practices (ranging from 0.02 to 0.67% of all attendances); 44.2% of the attendances included tooth-related problems, and 42.3% were for diseases of soft tissue, salivary glands or the tongue. On average patients with dental problems attended their doctor twice as frequently as other patients. The majority (75%) of oral/dental attendances were related solely to these problems. Patients with tooth-related dental problems were three times more likely to seek treatment at weekends than patients attending for other reasons. CONCLUSIONS: The rate of attendance for oral/dental problems varies substantially between practices, but is generally low. The higher rate of attendance for tooth-related problems at weekends suggests that some of the attendances for oral problems might be related to a perceived or actual lack of dental services at these times.

Adolescent↗

[Prescription of generic drugs in general practice. Results of a survey of general practitioners].

BACKGROUND AND PURPOSE: Switching brand-name drugs to generics is reasonable and desired for economic reasons. Few data exist about problems, if any, during the switching in general practice. In this survey, the view of general practitioners (GPs) should be ascertained. METHODS: GPs in five counties in the German federal states Thüringen and Baden-Württemberg, who took part in a study on generic drug prescribing, were asked to complete a questionnaire about experiences and attitudes toward generic drug prescription. RESULTS: A total of 195 (84%) of 233 GPs answered the questionnaire. Two thirds (127/195) stated, that brands and generics are pharmacologically equivalent. Many of these GPs estimated to prescribe generic drugs in > 50% of instances; fewer doctors did so, if they had doubts as to the equivalence of generics (65% vs. 46%; p < 0.05). Nearly 8% reported generics being less effective, and 10% observed new adverse effects after switching. Many GPs appointed the following barriers: cooperation with hospitals and colleagues (86%), GP's lack of time (68%), and communication problems with the patient (50%). GPs estimated that > 10% of patients strictly reject generic drugs. CONCLUSION: An optimized cooperation between GPs and hospital physicians could facilitate the consumption of generic potential in pharmacotherapy. Reasons for the obvious contrast between the proven pharmacological equivalence of brand-name and generic drugs and the problems encountered after switching reported by GPs should be further studied.

Adult↗