General Practice Flashcards
What are the roles of a GP?
1st point of contact
Promote healthy lifestyles
Provide holistic care, i.e. look at the patient as a person rather than just treating the illness
What personal qualities must a GP possess?
Commitment to providing highest possible quality of care to patient and relatives
Awareness of one’s own limitations and to seek help when needed
Reflecting and improving practice and performance
Excellent communication skills for working as part of a multi-disciplinary team
Clinical competence and organisation skills
Relating to the public
Able to deal with uncertainty
In what ways has GP practice changed over the years?
Medical records are now electronic instead of traditional paper
Fewer smaller/rural GP practices and larger GP practicies - longer patient waiting lists
Staff roles developing - staff taking on more diverse roles
How is a GP like running a business?
Most GP’s are independent contractors - can own the practice or run in partnership
GP’s responsible for running staff and business issues
What are the benefits of electronic record keeping?
Easy access by multiple staff at same/any time
No risk of losing electronic records
Software assists by storing appointment times, assists in consultations, supports prescribing and allows GP to write referral letters and receive blood results.
What are the names of the electronic systems used in GP?
Main systems are EMIS and Vision
How is being a GP flexible and good for the work-life balance?
Can decide their own pattern of work
Can take on other roles - working in a university or hospital to keep jobs exciting
Can choose session numbers per week - half day each week
Can opt in/out of providing out-of-hours care
How can a GP prepare for appraisal?
Reading literature
Attending courses
Performing audits
How often is a GP revalidated?
Every 5 years
Which staff members are part of the practice team and briefly describe their roles?
IT staff - manage and recall patients for clinics and immunisations
Nurses - blood taking, dressings etc
Nurse practitioner - similar role to GP, help to manage chronic conditions such as diabetes and asthma
Manager - deals with business affairs
Reception staff - assist with appointments, phone out blood results and keep records updated
Phlebotomist/Healthcare assistant - perform venipunctures for blood tests for example
What is longitudinal care in GP?
Seeing patients long term - GP’s may see patients from when they were born right through until their middle age. Need to consider home life and background - what’s “normal” for the patient
Why is effective communication important?
Proven to improve:
Patient satisfaction
Recall
Understanding
Concordance and compliance
Outcomes of care
What 4 factors are involved in clinical competence?
Knowledge
Communication
Physical examination
Problem solving
What skills are part of successful medical interviewing?
Content skills - what the doctor says (Q + As)
Perceptual skills - thinking, feeling; making internal decisions
Process skills - how the doctor carries out the practice
What factors influence consultations?
Physical and personal factors
What are the question types?
Open-ended, direct, closed (yes/no), leading and reflected
Describe the guidance/cooperation relationship
Doctor uses much authority and patient is obedient.
Greater feeling of autonomy and active participation
What are four inportant points to consider when using body language?
Culture, context, gesture clusters and congruence
What are the physical factors influencing consultations?
Site and environment.
Adequacy of medical records.
Time constraints.
New or known patient/problem.
What techniques are used in a consultation?
Open-ended questions.
Listening and silence - allow patient to talk.
Facilitation - directing convo appropriately.
What are the benefits of the mutual participation relationship?
Patient has larger responsibility for his/her own treatment.
Greater sense of autonomy and involvement.
Improved patient compliance.
Greater patient satisfaction.
What 3 activities are involved in a consultation?
Talking together - history taking (always)
Physical examination (often)
Procedures (sometimes)
Describe an authoritarian relationship.
Doctor uses all authority and patient gets very little/no input in making decisions for treatment.
No autonomy.
Patient tries to please the doctor.
No active participation in treatment.
What are the kinds fo doctor-patient relationships?
There are 3:
Authoritarian/Paternalistic
Guidance/Cooperation
Mutual Participation (most desirable)
What are the personal factors influencing consultations?
Age - younger patients prefer younger doctors; older patients prefer older doctors.
Sex - sometimes the same sex doctor can help a patient feel more comfortable.
Backgrounds - social class and ethnicity (language differences).
Knowledge/skills - doctors should be aware of using jargon, etc.
Beliefs - GPs can have different morals/beliefs to patient; ideally, these shouldn’t interfere with practice.
Illness - severity e.g. terminal illness; what is it?
If there is a typical GP day, explain one.
Morning and afternoon surgeries.
Paperwork - results, letters, reports.
Phone calls - planned appointments or telephone triages.
House calls.
Duty doctor/emergencies.
Specialist clinics e.g. minor surgeries, coils, joint injections, etc.
Practice business/staff issues.
