scholarly journals General Doctor's Consultation Work Begins before Entering the Patient and does not End when Patient Comes Out

2020 ◽  
Vol 1 (2) ◽  
pp. 6-14
Author(s):  
Jose Luis Turabian
Keyword(s):  
Health Promotion ◽  
General Practitioner ◽  
Previous History ◽  
General Medicine ◽  
Management Plan ◽  
Case Finding ◽  
Limited Resources ◽  
Technology Skills ◽  
Good Relationship ◽  
Quality Framework

The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.

scholarly journals Relasi Antara Investor Pariwisata Dengan Masyarakat Lokal Di Desa Pakraman Laplapan Desa Petulu Kecamatan Ubud

2018 ◽  
Vol 5 (1) ◽  
pp. 51
Author(s):  
I Ketut Agus Gita Suprapta ◽  
I Gusti Agung Oka Mahagangga
Keyword(s):  
Social Conflict ◽  
Outer Zone ◽  
Limited Resources ◽  
Middle Zone ◽  
Literature Study ◽  
Tourist Destination ◽  
Economic Resource ◽  
Good Relationship ◽  
The Relationship

The research titled is "relationship between tourism investors and lokal communities in Desa Pakraman Laplapan Petulu Village (Case Study Social Conflict)", purpose to understand the relationship undertaken by tourism investors with lokal communities that happened in the Ubud tourist destination. Data were collected through observation, interview and literature study. Infoman taken by purposive, which determine the informan with a certain considerations that are considered able to provide data to the maximum in accordance with the criteria of the research objectives. The collected data were analyzed descriptively qualitative. An important concept in the study include the concept of Typology Relations Styling in 3 Zone which consists of the outer zone, the middle zone and center zone. The results of this study indicate that, Desa Pakraman Laplapan as a region lies in the outer zone. Relationships that lived between tourism investors and lokal communities in Desa Pakraman Laplapan patterned conflictual. This pattern is shown by the regulation provided by the lokal community to tourism investors who are less rational. As for the view of the conflict is a way to snatch for limited resources. And one of them is the economic resource owned by the investor. Styling tourism investor relations with the lokal community in Desa Pakraman Laplapan has been sticking to the surface of the endless conflict. In this case, the farmer must make good relationship with tourism investors because it would help to farmers.   Keywords: Relationship, Investors, Lokal Communities, Conflict

scholarly journals The Concept of Minimalist Interventions in General Medicine: Minimum Means, Maximum Effect

2019 ◽  
Vol 2 (1) ◽  
pp. 01-06
Author(s):  
Jose Luis Turabian
Keyword(s):  
General Practitioner ◽  
Large Scale ◽  
Low Cost ◽  
General Medicine ◽  
Medical Intervention ◽  
Maximum Effect ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Less Is More ◽  
The Impact

Practical work requires deepening in the theory. In this way, the intention of this article is to systematize the concept of "minimal interventions", as well as draw attention to the impact that this type of interventions of the general practitioner can have on the patient, however small and insignificant, their action may seem. The doctor-patient relationship creates contexts that act, in one way or another, on the patient. There is no absence of medical intervention, even when there is no conscious intervention of the doctor on the patient. Non-intervention is a type of intervention. Non-intervention is a bio-fiction. The different types of doctor-patient relationship give rise, naturally, perhaps imperceptibly, to different models of educational intervention. In this scenario, a conceptualization and systematization of the "micro-interventions" in general medicine is presented: minimal, imperceptible, briefs, low cost, zen, human size, opportunistic, small and mild, but continuous interventions. These micro-interventions are cost-effective no matter how small and insignificant their action seems. These minimal interventions of the general practitioner are of great importance and constitute an updated form of the "less is more" rationalist, they express the power of the minimum gesture in general / family medicine, and can transform health / disease on a large scale. In this way we can hypothesize a plausible relationship between the minimal but concentrated and powerful means, that is to say "contextualized", and the intensity of the effect in general medicine. The clarity of the reading of a message depends on the appreciation of the context; what counts is not what, but how. The context highlights or "pulls" the message. Many small people, in small places, doing small things, can change the world.

scholarly journals Are we missing ‘previously treated’ smear-positive pulmonary tuberculosis under programme settings in India? A cross-sectional study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 338
Author(s):  
Hemant Deepak Shewade ◽  
Vivek Gupta ◽  
Srinath Satyanarayana ◽  
Atul Kharate ◽  
Lakshmi Murali ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Past History ◽  
National Level ◽  
Previous History ◽  
Case Finding ◽  
Active Case Finding ◽  
Active Case ◽  
Tb Treatment ◽  
History Of ◽  
Previously Treated

Background: In 2007, a field observation from India reported 11% misclassification among ‘new’ patients registered under the revised national tuberculosis (TB) control programme. Ten years down the line, it is important to know what proportion of newly registered patients has a past history of TB treatment. Methods: A study was conducted among new smear-positive pulmonary TB patients registered between March 2016 and February 2017 in 18 randomly selected districts to determine the effectiveness of an active case-finding strategy in marginalised and vulnerable populations. We included all patients detected through active case-finding. An equal number of randomly selected patients registered through passive case-finding from marginalised and vulnerable populations in the same districts were included. Before enrolment, we enquired about any history of previous TB treatment through interviews. Results: Of 629 patients, we interviewed 521, of whom, 11% (n=56) had past history of TB treatment (public or private) for at least a month: 13% (34/268) among the active case-finding group and 9% (22/253) among the passive case-finding group (p=0.18). No factors were found to be significantly associated with misclassification. Conclusion: Around one in every ten patients registered as ‘new’ had previous history of TB treatment. Corrective measures need to be implemented, followed by monitoring of any change in the proportion of ‘previously treated’ patients among all registered patients treated under the programme at national level.

Pilot Evaluation of the Informant AD8 as a Case-Finding Instrument for Cognitive Impairment in General Practitioner Clinics of Singapore: A Brief Report

2016 ◽  
Vol 17 (12) ◽  
pp. 1147-1150 ◽  
Author(s):  
Esther Yee Shuang Wan ◽  
Muhammad Amin Shaik ◽  
Amir Adhha ◽  
Richard Mong Hoo Ng ◽  
Claire Thompson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
General Practitioner ◽  
Case Finding

scholarly journals The general practitioner and the surgeon: stereotypes and medical specialties

2004 ◽  
Vol 59 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Patrícia Lacerda Bellodi
Keyword(s):  
General Practitioner ◽  
General Medicine ◽  
Medical Residents ◽  
Medical Specialties ◽  
Considerable Similarity ◽  
Close Relationship ◽  
History Of ◽  
Gender Characteristics ◽  
Manual Skills ◽  
Intellectual Skills

OBJECTIVE: To investigate and characterize the professional stereotypes associated with general medicine and surgery among Brazilian medical residents. METHODS: A randomized sample of residents of the General Medicine and Surgery Residence Programs were interviewed and their perceptions and views of general and surgical doctors were compared. RESULTS: The general practitioner was characterized by the residents in general to be principally a sensitive and concerned doctor with a close relationship with the patient; (45%); calm, tranquil, and balanced (27%); with intellectual skills (25%); meticulous and attentive to details (23%); slow to resolve problems and make decisions (22%); and working more with probabilities and hypotheses (20%). The surgeon was considered to be practical and objective (40%); quickly resolving problems (35%); technical with manual skills (23%); omnipotent, arrogant, and domineering (23%); anxious, stressed, nervous, and temperamental (23%); and more decided, secure, and courageous (20%). Only the residents of general medicine attributed the surgeon with less knowledge of medicine and only the surgeons attributed gender characteristics to their own specialty. CONCLUSION: There was considerable similarity in the description of a typical general practitioner and surgeon among the residents in general, regardless of the specialty they had chosen. It was interesting to observe that these stereotypes persist despite the transformations in the history of medicine, i.e. the first physicians (especially regarding the valorization of knowledge) and the first surgeons, so-called "barber surgeons" in Brazil (associated with less knowledge and the performance of high-risk procedures).

scholarly journals General practitioner and health promotion: what patients think.

BMJ ◽  
1984 ◽  
Vol 289 (6444) ◽  
pp. 534-536 ◽  
Author(s):  
P G Wallace ◽  
A P Haines
Keyword(s):  
Health Promotion ◽  
General Practitioner

Chronic disease management: does the disease affect likelihood of care planning?

2012 ◽  
Vol 36 (4) ◽  
pp. 419 ◽  
Author(s):  
Agnes I. Vitry ◽  
Elizabeth E. Roughead ◽  
Emmae N. Ramsay ◽  
Philip Ryan ◽  
Gillian E. Caughey ◽  
...  
Keyword(s):  
Chronic Disease ◽  
General Practitioner ◽  
Disease Management ◽  
Chronic Diseases ◽  
Chronic Disease Management ◽  
Health Assessment ◽  
Management Plan ◽  
Department Of Veterans Affairs ◽  
Allied Health Professionals ◽  
Use Of Services

Objective. To compare the demographic, socioeconomic, and medical characteristics of patients who had a General Practitioner Management Plan (GPMP) with those for patients without GPMP. Methods. Cohort study of patients with chronic diseases during the time period 1 July 2006 to 30 June 2008 using the Australian Department of Veterans’ Affairs (DVA) claims database. Results. Of the 88 128 veterans with chronic diseases included in the study, 23 015 (26%) veterans had a GPMP and 11 089 (13%) had a Team Care Arrangement (TCA). Those with a GPMP had a higher number of comorbidities (P < 0.001), and a higher use of services such as health assessment and medicine review (P < 0.001) than did those without GPMP. Diabetes was associated with a significantly increased use of GPMP compared with all other chronic diseases except heart failure. Conclusions. GPMPs are used in a minority of patients with chronic diseases. Use is highest in people with diabetes. What is known about the topic? Despite the fact that the Chronic Disease Management (CDM) program is appreciated by patients and allied health professionals, limited research has assessed how it is used in practice. What does this paper add? In the Veteran population, use of a General Practitioner Management Plan (GPMP) was associated with a higher number of comorbidities and of prior hospitalisations. Across chronic diseases use of GPMPs was low but was higher in people with diabetes. What are the implications for practitioners? Further research into the effect of CDM program on improvement of health outcomes is required.

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