An overview of general practitioner consultations in China: a direct observational study

2020 ◽  
Vol 37 (5) ◽  
pp. 682-688 ◽  
Author(s):  
Chenwen Zhong ◽  
Zhuojun Luo ◽  
Cuiying Liang ◽  
Mengping Zhou ◽  
Li Kuang
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Treatment Planning ◽  
Patient Activation ◽  
Patient Characteristics ◽  
History Taking ◽  
Planning History ◽  
Consultation Process ◽  
Visit Duration ◽  
Observation Code

Abstract Background General practitioner (GP) consultation has long been considered an important component of general practice, but few studies have focused on its characteristics in China. Objective This study aimed to explore the content and elucidate the characteristics of GP consultations in general practice in China. Methods A multimethod investigation of GP consultations in eight community health centres in Guangzhou and Shenzhen, China was conducted between July 2018 and January 2019. Data from 445 GP consultations were collected by direct observation and audio tape and analysed by a modified Davis Observation Code with indicators for frequencies and detailed time durations. GP and patient characteristics were collected by post-visit surveys. Results The mean visit duration was approximately 5.4 minutes. GPs spent the most time on treatment planning, history taking, negotiating, notetaking and physical examination and less time on health promotion, family information collecting, discussing substance use, procedures and counselling. The time spent on procedures ranked first (66 seconds), followed by history taking (65 seconds) and treatment planning (63 seconds). Besides, patients were very active in the consultation, specifically for topics related to medicine ordering and drug costs. Conclusions This study described the profile of GP consultations and illustrated the complexity of care provided by GPs in China. As patient activation in GP consultations becomes increasingly important, future studies need to explore how to promote the engagement of patients in the whole consultation process other than just requesting for medicine.

scholarly journals Acute red eye in children: A practical approach

2020 ◽  
Vol 49 (12) ◽  
pp. 815-822
Author(s):  
Siyuan Jabelle Lu ◽  
Graham A Lee ◽  
Glen A Cole
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Wide Spectrum ◽  
Practical Approach ◽  
History Taking ◽  
Red Flags ◽  
Red Eye ◽  
Urgent Referral ◽  
Red Eyes

Background Acute red eye in a child is a common ocular presentation in general practice. It can arise from a wide spectrum of pathologies and involve various ocular structures. Objective The aim of this article is to provide a framework for the general practitioner to assess and manage a child presenting with a red eye, with a focus on cases that require immediate referral. Discussion Most paediatric red eyes are benign and can be safely managed in general practice. However, this requires thorough history-taking and examination together with the ruling out of red flags. Assessment of a child with a red eye may pose specific challenges that can usually be overcome by focused history-taking and opportunistic examination. Urgent referral for examination under sedation or anaesthesia is indicated when there is suspicion of a vision-threatening cause and/or assessment in the clinic is unsuccessful.

scholarly journals The Somatizing Patient in General Practice

1994 ◽  
Vol 24 (2) ◽  
pp. 157-177 ◽  
Author(s):  
P. F. M. Verhaak ◽  
M. A. R. Tijhuis
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Exploratory Study ◽  
Patient Characteristics ◽  
Somatic Complaints ◽  
Dependent Types ◽  
Physical Complaint ◽  
Social Nature ◽  
Mental Problems ◽  
Research Period

Objective: The exploratory study described in this article followed two groups of patients over a twelve-month period. Subjects were drawn from a pool of patients who had consulted their general practitioner during the three-month selection period. One group consisted of patients who had consulted their general practitioner at least once about a physical complaint that the GP regarded as predominantly psychosocial; these patients did not articulate complaints of an explicitly mental or social nature. The second group was characterized by the fact that its members voiced precisely such mental or social complaints. Method: The study investigated the extent to which the two groups (which were comparable in the severity of their complaints) differ with respect to patient characteristics such as the severity of their possible psychological problems, the frequency with which they visited their GPs, and the types of complaints—e.g. mental, psychosomatic and purely physical—they presented. Results: It was found that patients in the first group, whose somatic complaints were seen to have a psychosocial basis, are not the dependent types generally mentioned in theories about somatization. In fact, they adopt a more independent attitude to the GP than do patients voicing mental complaints. There are indications that for “somatizing” patients, underlying mental problems are less important than for “psychologizing” patients. Conclusions: Both the somatizing patients and the psychologizing patients continued very frequent visits to their GP during the 12-month research period, although chiefly to address physical complaints that the GP also assessed as such.

scholarly journals Standing order use in general practice: the views of medicine, nursing and pharmacy stakeholder organisations

2017 ◽  
Vol 9 (1) ◽  
pp. 47 ◽  
Author(s):  
Robyn Taylor ◽  
Eileen McKinlay ◽  
Caroline Morris
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Access To Health Care ◽  
Timely Manner ◽  
Face To Face ◽  
Standing Order ◽  
Access To Health ◽  
General Practices ◽  
Pharmacy Data ◽  
The Impact

ABSTRACT INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders’ views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

An acute eye condition masquerading as a flu-like syndrome: A potential pitfall in general practice

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Evita Evangelia Christou ◽  
◽  
Xenophon Bazoukis ◽  
Alexandra Papoudou-Bai ◽  
Maria Stefaniotou ◽  
...  
Keyword(s):  
General Practice ◽  
Differential Diagnosis ◽  
General Practitioner ◽  
Gastrointestinal Symptoms ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Potential Pitfall ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Systemic Condition

Acute primary angle closure glaucoma may masquerade a systemic condition. Proper differential diagnosis is requisite. A 52-year-old female visited the general practitioner due to her progressively worsening headache accompanied by gastrointestinal symptoms. This condition presented acutely while reading a book at semiprone position in a not well illuminated room.

Going to See the Doctor: The Consultation Process in General Practice.

1976 ◽  
Vol 5 (6) ◽  
pp. 776
Author(s):  
Gary L. Burkett ◽  
Gerry V. Stimson ◽  
Barbara Webb
Keyword(s):  
General Practice ◽  
Consultation Process

Psychiatric disorders in adolescents in primary care

1998 ◽  
Vol 173 (6) ◽  
pp. 508-513 ◽  
Author(s):  
Tami Kramer ◽  
M. Elena Garralda
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioner ◽  
Psychiatric Disorders ◽  
Health Risks ◽  
Physical Symptoms ◽  
Global Assessment Scale ◽  
Scale Scores ◽  
Research Interviews ◽  
Internalising Disorders

BackgroundLittle is known about psychiatric disorders in adolescents who attend primary care.MethodProspective study of 13- to 16-year-olds consecutively attending general practice. Information was obtained from adolescents, parents and general practitioners, using questionnaires and research interviews.Results136/200 (68%) of adolescent attenders took part. Two per cent presented with psychiatric complaints. From research interviews with adolescents, psychiatric disorder in the previous year was found in 38%, with moderate impairment of functioning in over half (according to Children's Global Assessment Scale scores). Most disorders (42/50, 84%) were emotional (‘internalising’) disorders. Psychiatric disorders were significantly associated with high levels and intensity of physical symptoms and with increased health risks. General practitioner assessment of psychiatric disorders was low on sensitivity (20.8%) but high on specificity (90.7%). Doctors identified most severely affected adolescents.ConclusionsDepressive and anxiety disorders are common among adolescent general practice attenders and linked to increased physical symptoms; general practitioner recognition is limited.

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