General Practice Flashcards
What are some personal qualities of an effective GP?
- Commitment to high quality care
- Awareness of one’s own limitations
- Ability to seek help when appropriate
- Commitment to keeping up to date and improving quality of one’s own performance
- Appreciate value of teamwork
- Good interpersonal and communication skills
- Organisational ability
- Others
What are GPs responsible for in the running of the business?
Independent contractors; responsible for running the business affairs of the practice, providing adequate premises and infrastructure to provide safe patient services and employ and train practice staff
Advantages of digital record keeping
Patient data can be accessed by any approved member of the staff in any place at any time; patient data can be listed, graphed and searched easily, enabling GP’s to convey and track info in an effective manner
Uses of practice IT systems
- Store appointments
- Book appointments
- Assist in consultations (patient records)
- Support prescribing
- Electronic management of hospital letters
- Electronic management of blood/other results
- Use in audit
- E-consultations
- Chronic disease management and recall
- Patient leaflets/resources
- Public health information
- Identify patients for screening programmes
How does a GP prepare for their 5-yearly appraisal?
Reading literature, attending courses and performing audits
List members of the Practice Team
- Manager
- IT/Admin staff
- Secretarial staff
- Reception staff
- Nurses - junior and senior
- Advanced nurse practitioners/Physician assistants
- Phlebotomists/Health Care assistants
4 essential components of clinical competence
- Knowledge
- Communication skills
- Physical examination
- Problem solving
3 broad types of skills for successful medical interviewing
- Content skills = what doctors communicate
- Perceptual skills = what they are thinking or feeling
- Process skills = how they do it
Physical factors influencing consultation
- Site and environment
- Adequacy of medical records
- Time constraints
- Patient status (new patient or old; new problem or old)
Personal factors influencing consultations
- Age
- Sex
- Backgrounds and origins
- Knowledge and skills
- Beliefs
- The illness
3 different doctor-patient relationships
- Authoritarian or paternalistic = physician used all authority and status and patient feels no autonomy
- Guidance/co-operation = physician still exercises much authority and the patient is obedient, but has a greater feeling of autonomy and participates more actively
- Mutual participation = most desirable; patient has a feeling of autonomy and active participation created by appropriate moderation of the doctor’s use of authority
Closed interview
Similar to a written questionnaire; interrogation type interview
Open interview
Doctor listens and facilitates, then discusses possible ways forward with the patient acting in partnership
Interviewing techniques
- The open-ended question
- Listening and silence
- Facilitation
Types of question
- Open = not seeking a particular answer, signals to patient to tell their story
- Closed = can only be answered ‘yes’ or ‘no’
- Direct = asks about a specific item
- Leading = presumes the answer and is best avoided
- Reflective = allows the doctor to avoid answering a direct question
