FOPC 1

Question 1

Who is involved in community care

Answer 1

• GP
• Dietician
• Psycologist
• Pharmacists
• Nurses (school and midwifes)
• Health educators
• Physiotherapist
• Councellor

Question 2

Who else makes up the GP team

Answer 2

• Locum GP
• Nurses including nurse practitioners
• Phlebotomists
• Managers
• IT staff- in charge of repeat prescriptions
• Receptionists- booking appointments
• Secretary

Question 3

Which specialties are available

Answer 3

• GP
• Environmental medicine
• Public health

Question 4

What other events can be covered by GPS

Answer 4

• Out of hours responsabilities
• BASICS- british association for Immediate care
• Events coverage
• Portfolio careers: short time roles

Question 5

Definition of Gp as a gatekeeper

Answer 5

They are involved in co-ordinating the health care of the patient: in charge of all their referrals and their transition into secondary/ specialist care

Question 6

Advantages of being a gatekeeper

Answer 6

• continuity of care
• makes sure the patient is sent to the right place
• reduces costs and wating times in secondary/specialist care
• Stregthens the dr-patient relationship
• reduces exposure to dangers such as MRI radiation
• Puts dr in charge of patient education

Question 7

Disadvantages of being a gatekeeper

Answer 7

• GPs need to be more knowledgeable in certain areas
• Could strain relationship if things go wrong
• Patient has less control over whole health care
• More stress on GP

Question 8

Skills which are used by a GP

Answer 8

• Holistic approach
• Assess risk and uncertainty
• Problem solving- hypothetical deductive reasoning
• A variety of clinical skills
• Evidence based medicine

Question 9

Skills which medical students need to acquire in order to become good doctors

Answer 9

• Awareness of self limitations
• Ability to ask for help when required
• Good team work
• Ability to keep up to date and improve self-performance
• Good interpersonal skills and ability to communicate with others
• The ability to deal with risk and uncertainty
• Good organizational skills
• Ability to care for patients AND THEIR RELATIVES
• A commitment to deliver high quality of care

Question 10

Factors which allow a dr to provide best quality of care

Answer 10

• Awareness of patients current and past medical history
• Awareness of patients social circumstances
• Local so readily available
• Tend to follow patients for a long period of time so develop a relationship with them-ARE TRUSTED
• GP has a huge variety of skills and knowledge
• Holistic approach: involved not only in diagnosing but also in preventing

Question 11

Perks of being a GP

Answer 11

• good work-life balance
• A GP is an independent contractor so can choose how many sessions to work
• One session is ½ days work
• Since out of hours contract GPs no longer have to cover weekends and night hours

Question 12

GP learning

Answer 12

• Continuos process
• Revalidation every 5 years
• GP must prepare for appraisals by reading literature, attending audits
• Audits are held with other medical professionals

Question 13

Running a GP clinic

Answer 13

• Like running a business

- In charge of making sure both infrastructure and medical practice meets the standards to provide safe medical practice

Question 14

What is IT in Gps used for

Answer 14

• Store and book appointments
• Electronic management of hospital referral letters
• Electronic management of blood tests and results
• Keep a copy of patient records which helps during consultations
• Can be used in audits
• To manage chronic diseases and recall for immunisations
• repeat prescriptions
• to identify patients for screening programmes

Question 15

Meaning of longitudinal care

Answer 15

Care of patient from baby to age of 40

Question 16

4 essential components of clinical competence:

Answer 16

• Communication skills
• knowledge
• Physical examination
• Problem solving

Question 17

Skills which a GP must have when conducting a medical interview

Answer 17

• Content skills- What they communicate and what they gather
• Perceptual skills- What the doctors Is feeling. Awareness of own bias, attitudes and thoughts
• Process skills: How the doctors goes about gathering and giving information. Combination of verbal and non-verbal reasoning. Ability to provide structure to the way they conduct their interview

Question 18

Factors which affect a consultation

Answer 18

Physical

• Environment : Safe space of a GP clinic/ED rather than in a caotic environment such as a car crash
• State of medical records
• Time constraints of consultations
• Patient status e.g. new patients/old patients with known conditions or unknown conditions

Personal factors:

• Age
• Gender
• Ethicity/background
• Knowledge/skill: Drs may feel more pressured if they are consulting someone else in the profession as they feel they might have more experience than them
• The illness: more difficult to conduct a consultation in which you are informing the patient they have a terminal illness

Question 19

Types of DR-patient relationship

Answer 19

Authoritarian/paternalistic: DR in charge of care. Patient has no autonomy- is not actively involved in their treatment
Guidance/Co-operation: Dr still has more autonomy but patient is more involved- has some say in their treatment
Mutual participation: Active participation of both dr and patient. Patient feels some responsibility for a successful outcome.

Question 20

The consultation is made up of three separate activities:

Answer 20

• Talking together: always
• Examination: often
• Procedures: sometimes

Question 21

Skilled interviewer qualities

Answer 21

Will communicate their treatment plan to the patient in a clear way they understand without frightening them

• Will involve the patient in their own care
• Build a relationship which will ensure that relevant issues are made clear early on

Question 22

Question types

Answer 22

• open ended questions
• closed questions -YES/NO
• Reflective questions-
• Direct questions – asks about a specific facor
• Leading questions- presumes the answer

Question 23

Non verbal communication

Answer 23

-Instinctive : crying, laughing
-Learned:
From life experience
From training
-Clinical observation

Question 24

Body language

Answer 24

Study of body language helps observation and communication and therefore patient care:

Culture- certain body languages must be taken into consideration
Gestures clusters- re-inforce information
Context- body language due to pain which is not related to non-verbal messages
Congruence: Lack of congruence (agreement) may be a sign of omission. Non-verbal language carries more significance in these circumstances than verbal language

Gaze behavior:
Lack of eye contact can indicate patient is holding back information/ is being dishonest
Posture:
Depressed patients are usually slouched
Nervous patients are usually restless
Specific gestures
Crossed arms/clutching a handbag may be signs of distress

Hand to face gestures: can indicate doubt/ uncertainty

• holding face to hand- indicates boredom
• clenched hand- patient is holding back negative attitude
• chin, cheek- indicate interest
• Index finger indicated negative thoughts

Question 25

Role of GP?

Answer 25

• promoting healthy life style
• Caring for whole person and not just their illness
• Main interface between community and NHS
• First point of contact