Australian Family Physician January 2006 - Working smarter
Vol 35, No. 1/2 (1-80)
The theme for the January/February issue of AFP
is working smarter. Articles include General practice and the management
of chronic conditions, Using computers to work smarter and Incorporating
medical students into your practice.
Working smarter
Jenni Parsons
This year marks the 50th anniversary of the first publication of Annals
of general practice, the journal of the College of General Practice in
Australia, which subsequently evolved into Australian Family
Physician.
Letters to the editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners.
EPC encounters in Australian general practice
Julie O'Halloran, Anthea Ng, Helena Britt, Janice Charles
The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of
the content of Enhanced Primary Care (EPC) encounters in Australian general practice. The EPC program was introduced on 1 November 1999, and contained three major aspects of care - health assessments, care plans and case conferences.
Prevention. Building on routine clinical practice
Moira G Sim, Eric Khong
The role of general practice in preventing disease and promoting health
is strongly supported by research and health policies.
General practice and the management of chronic conditions. Where to now?
Jan Newland, Nicholas Zwar
As of 1 July 2005, the Medicare Benefits Schedule includes additional
chronic disease management (CDM) item numbers offering general
practitioners more options for managing patients with chronic
conditions, including those requiring multidisciplinary care. The new
item numbers are not a substitute for normal medical care but expand
the possibilities for GPs and their patients.
Practice nurses. Working smarter in general practice
Lynne Walker
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.
Incorporating medical students into your practice
Dawn E DeWitt
Teaching is fun and intrinsically rewarding. It helps doctors to
refresh their knowledge base, improves morale, and adds variety to
routine practice. However, it does take time.
Using computers to work smarter. A guide for GPs
Peter Schattner
Computers have many uses in general practice, but to get the most out of them requires commitment of time and money.
Getting evidence into practice using an asthma desktop tool
John Campbell, Sharon Campbell, Glenda Woodward
Failure to utilise evidence in asthma care is leading to avoidable
asthma symptoms for sufferers and costs to health services.
Getting the most out of your practice. The Practice Health Atlas and business modelling opportunities
Peter Del Fante, Don Allan, Elizabeth Babidge
Practice Health Atlas (PHA) is a decision support tool for general
practice, designed by the Adelaide Western Division of General Practice
(AWDGP).
Cancer screening. Benefits, harms and making an informed choice
Alexandra L Barratt
Screening is a two edged sword, with potential benefits and harms.
Despite professional and public enthusiasm for cancer screening there
are substantial harms, and increasing evidence that it is not always a
good idea to detect cancer early. On the other side, the benefits of
cancer screening are quite rare and have been oversold.
An approach to the patient with a family history of breast cancer. Benefits, harms and making an informed choice
Judy Kirk, Meagan Brennan, Nehmat Houssami, Owen Ung
This eleventh article in our series on breast disease discusses the
management of a patient with a family history of breast disease. Apart
from increasing age and female gender, family history is the most
important risk factor for breast cancer. However, women with a family
history of breast cancer often overestimate their risk of developing
the disease. Much of the clinician's role is to reassure the patient
and clarify the risk based on a careful assessment of the family
history.
Diabetes and the skin. Part 4 - diabetic bullae
Pat Phillips, Warren Weightman
Jane is showing you her latest 'blister'. The blister is thick walled,
doesn't break down and heals without scarring. Jane is 72 years of age
and has had type 2 diabetes for 25 years requiring insulin over the
past 15 years.
Family history of breast cancer
NSW Breast Cancer Institute
Breast cancer is a common disease. In Australian women, the lifetime
risk of developing breast cancer is one in 11. While family history is
a recognised risk factor, many women will have someone in their family
who has had breast cancer.
Basic black
Tom Gavranic
I have found that painting one entire consulting room wall (preferably
behind you) with blackboard paint and then using chalk is a remarkably
cheap and very effective tool.
Chronic itchiness of the hands
Keng Yin Loh, Cheong Lieng Teng
A factory worker from Malaysia, 21 years of age, presents with itchy
rashes over both her hands of 6 months duration.
Identifying and training effective clinical teachers. New directions in clinical teacher training
Eugen Molodysky, Natasha Sekelja, Claudia Lee
Decisions about recruitment of clinical teachers and about the content
of clinical teacher training programs are complex.
Clinical Challenge
Questions for this month’s clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.
Prescribing Schedule 8 drugs
Sara Bird
This article examines a general
practitioner's legal obligations when prescribing Schedule 8 drugs
(drugs of addiction), with particular emphasis on dealing with patients
who are drug dependent.
I'm just ringing for some advice... Issues concerning GP advice lines
Danielle Mazza, Susan Kermond, Claire Harris
In response to the increasing demand for emergency department and
outpatient services, many hospitals are establishing general
practitioner advice lines.
Resilience promotion. Its role in clinical medicine
Murray Lloyd
There is an increased awareness of the words 'resilience' and 'spiritual' in both the community and the media.
Research capacity building in general practice. A new opportunity in Fremantle, WA
Tom Brett, Rachel Sherrard, Adrian Bower
One of the great disappointments of primary care medicine has been the
failure to develop a strong research tradition among general
practitioners.
Obituary: John Robinson Marshall (1929-2005)
With great sadness, The Royal Australian College of General Practitioners notes the passing of John Robinson Marshall, AM, better known as 'Jack' - friend, colleague, doctor, and mentor to many.
Grey nomads. Health and health preparation of older travellers in remote Australia
Joel Tate, Jacki Mein, Hayley Freeman, Graeme Maguire
Many older Australians now tour remote Australia (so called 'grey
nomads'). Anecdote suggests they place a burden on limited remote
health services, however, this burden is poorly documented.
Improving collaboration between community mental health services and GPs
Megan Wright, Karen Harmon, Terry Lewin
In 1998, the second National Mental Health Plan in Australia
highlighted a need to improve partnerships between mental health
services and general practitioners so as to improve mental health care
delivery.
Characteristics of career advisors for general practice. A qualitative study of UK GPs
Andrew Thornett, Judith Thorley, Ruth Chambers
Career support needs of general practitioners are poorly described in the literature.
Monitoring change in diabetes care using diabetes registers
A Georgiou, J Burns, Ruth S McKenzie, MF Harris
The quality of care for
patients with type 2 diabetes has been the subject of a number of
government initiatives over the past decade.