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FoPC > General Practice > Flashcards

General Practice Flashcards

1
Q

What is general practice?

A

Caring for the whole person as well as their illness

The promotion of healthy lifestyles

First point of contact

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2
Q

What are some personal qualities to be a good GP?

A

Ability to care about people and relatives

Commitment to providing high quality care

Awareness of ones own limitations

Clinical competence

Organisational ability

Ability to work with others

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3
Q

Who owns the practice or building that GPs work in?

A

GPs themselves or the local NHS organisation

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4
Q

What kind of employment do most GPs have?

A

Self emplyed, either owning or running a business of their own in partership with others

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5
Q

What are responsibilities of GPs as a partner?

A

Running the business affairs

Providing adequate premises and infrastructure to provide care

Employ and train people

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6
Q

What aspect of the NHS is at the cutting edge of information technology?

A

General practice

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7
Q

Why is general practice considered to be at the cutting edge of information technology?

A

Leads the way for the move from paper to digital

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8
Q

What are advantages of moving from paper to digital?

A

Patient date easily accessed by approved members of staff

Can possibly be accessed remotely

Patient data can be listed, graphed and easily searched

Identify patients for screening programmes

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9
Q
A
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10
Q

What are the main information systems that GPs use?

A

Vision

EMIS

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11
Q

What does the use of vision or EMIS allow?

A

Store appointments

Assist in consultations

Support prescribing

Allow GPs to manage hospital letters and blood results electronically

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12
Q

What is a massive advantage of being a GP, in terms of work-life balance?

A

Ability to work flexibly

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13
Q

What other roles can GPs take on?

A

Working at a university as a lecturer

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14
Q

Why do GPs no longer have to provide out of hours services?

A

It was removed from the national GP contract in 2004

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15
Q

Why would GP practices provide out of hours services?

A

They get paid extra for doing so

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16
Q

What are GPs required to display in terms of learning?

A

Life long learning

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17
Q

What must GPs do to show they are still learning and adapting?

A

Undertake 5 year cycle in order to be revalidated

Meeting held with professional colleague and annual appraisal work is assessed

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18
Q

How do GPs prepare for revalidation?

A

Reading literature

Attending courses

Performing audits

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19
Q

What does the BMA recommend in regards to revalidation?

A

Salaried GP contract has time negotiated as protected for appraisal work

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20
Q

Who does the practice team consist of?

A

Manager

IT/admin staff

Secretarial staff

Reception staff

Nurses

Advanced nurse practitioner

Physician assistants

Health care assistants

General practitioners

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21
Q

GPs can choose a wide variety of career paths, what are some of these?

A

Parter

Take a special interest such as diabetes

Salaried GP to have better work life balance

Interest in education as a lecturer

Sports doctor for local football team

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22
Q

Why are GP practices well placed to be able to adapt to their communities?

A

Run by doctors

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23
Q

What is longitudinal care?

A

Holistic, dynamic and integrated plan that documents important disease prevention and treatment goals and plans

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24
Q

What does longitudinal care mean it is possible to do?

A

Assist with the neonatal care of a baby at the start of your career and still be looking after them when they turn 40

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25
Q

What are the advantages of getting to know families and them trusting you?

A

Consultations are quicker and easier

They have confidence in your knowledge and guidance

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26
Q

What is an emotional advantage, and disadvantage of looking after people with chronic conditions?

A

You get to watch them improve and deteriorate

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27
Q

How many consultations do GPs perform in a professional lifetime?

A

200,000

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28
Q

What do major problems with communication lead to?

A

Complaints such as “my doctor wont listen to me”

Misdiagnosis

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29
Q

What does effective communication improve?

A

Patient satisfaction

Patient recall

Patient understanding

Patient concordance

Outcomes of care

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30
Q

What are the 4 essential components of clinical competence?

A

Knowledge

Communication skills

Physical examination

Problem solving

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31
Q

What are 3 broad types of skills need for effective communication?

A

Content skills

Perceptual skills

Process skills

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32
Q

What are content skills?

A

What doctors communicate, the substance of their questions and responses, the information they gather and give, the treatments

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33
Q

What are perceptual skills?

A

What doctors are thinking and feeling, internal decision making, clinical reasoning, awareness of own bias, attitudes and distractions

34
Q

What are process skills?

A

How doctors do it, the way they communicate with patients, how they go about discovering the history or providing information, verban and nonverbal skills they use, the way they structure and organise communication

35
Q

What are 2 categories of factors that influence the consultation?

A

Physical factors

Personal factors (doctor and patient)

36
Q

What are examples of physical factors that affect the consultation?

A

Site and environment

Adequacy of medical records

Time constraints

Patient status (old vs new)

37
Q

What are personal factors that influence the consultation?

A

Age

Sex

Backgrounds and origins

Beliefs

The illness

38
Q

Who are the publics health beliefs mainly influenced by?

A

The media

39
Q

What is the general rule for age impacting a consultation?

A

Young patients prefer young doctors

Old patients prefer old doctors

40
Q

What is the general rule for sex affecting a consultation?

A

Patients prefer same sex doctors

41
Q

What are the 3 styles of doctor-patient relationships?

A

Authoritarian or paternalistic relationship

Guidance/co-operation

Mutual participation relationship

42
Q

What is an authoritarian or paternalistic relationship?

A

Patient feels no autonomy

Tries hard to please the doctor

Does not actively participate in their own treatment

43
Q

What kind of relationship does the patient feel no autonomy?

A

Authoritarian or paternalistic

44
Q

What is a guidance/co-operation relationship?

A

Doctor exercises much authority and the patient is obedient

But has greater feeling of autonomy and participates more in the relationship

45
Q

What kinds of relationship does the doctor exercise authority but the patient has a greater feeling of autonomy than others?

A

Guidance/co-operation

46
Q

What is a mutal participation relationship?

A

Most desirable and complex

Patient feels responsible for treatment by participating

47
Q

What kind of relationship does the patient feel responsible for treatment by participating?

A

Mutual participation relationship

48
Q

What are the 3 seperate activites involved in the medical consultation?

A

Talking together (always)

Doctor examining patient (often)

Performing procedures (sometimes)

49
Q

What are some different interviewing techniques?

A

Open ended questions

Listening and silence

Facilitation

50
Q

What is an example of an open ended question?

A

“What kind of troubles have you been having”

51
Q

What skill does listening and silence interviewing technique require?

A

Active listening

52
Q

What is the facilitation interviewing technique?

A

Encourages communication by using manner, gesture or words that do not specify the kind of information that is sought

53
Q

What are some examples of different kinds of questions?

A

Open ended questions

Direct questions

Closed questions

Leading questions

Reflected questions

54
Q

What are open ended questions?

A

Not seeking any particular answer but simply signals to the patient to tell their story

55
Q

What are direct questions?

A

Asks the patient about specific item

56
Q

What are closed questions?

A

Can only be answered with yes or no

57
Q

What are leading questions?

A

Presumes the answer

58
Q

What are reflected questions?

A

Allows the doctor to avoid answering a direct question

59
Q

What kind of questions should be avoided?

A

Leading question

60
Q

What does the use of questions too early in the interview do?

A

Restricts the amount of information recieved

61
Q

What is non-verbal communication also known as?

A

Body language

62
Q

What are the 3 categories of non-verbal communication?

A

Instinctive

Learned

Clinical observation

63
Q

What is an example of instinctive non verbal communication?

A

Crying

Expression of pain

Laughter

64
Q

What are different kinds of learned non-verbal communication?

A

From life experience

From training

65
Q

What is learned non-verbal communication for life experiences dependent on?

A

Family experiences and culture

66
Q

What is an example of clinical observation non-verbal communication?

A

Being aware of the patients pain

67
Q

What are 4 important points to be considered before interpreting body language?

A

Culture

Context

Gesture clusters

Congruence

68
Q

What should be remembered about body language and cultures?

A

Body language differs between cultures

69
Q

What should be remembered about body language and context?

A

Interpretation depends on context, such as is the patient’s posture due to pain or poor hearing

70
Q

Why are gesture clusters advantageous?

A

Single gesture can be misinterpreted, cluster of gestures re-enforces the message

71
Q

What is more reliable, non-verbal communication or words?

A

Non-verbal communication

72
Q

What can lack of congruence imply?

A

Omission

Inaccuracy

Suppresion of information

73
Q

What is congruence?

A

Agreement or harmony

74
Q

What is autonomy?

A

Patient makes decisions about their care

75
Q

What are some different examples of body language?

A

Gaze behaviour

Posture

Specific gestures (such as hand to face)

76
Q

What does eye contact indicate?

A

Interest

77
Q

What does fidgeting and moving around indicate?

A

Anxiety

78
Q

What does lack of eye contact indicate?

A

Person is being dishonest

79
Q

What do specific gestures tell you?

A

If the patient is comfortable with the topic or not

80
Q

What are examples of barrier specific gestures?

A

Folding arms, legs

Feet cross and ankle lock

81
Q

What does hand to face gestures indicate?

A

Doubt, uncertainty, lying or exaggeration

82
Q

What does holistic care refer to?

A

Healing the mind, body and soul of our patients

FoPC (45 decks)

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