Year 1 Flashcards
What percentage of medical graduates become GPs?
47%
Discuss the meaning of holistic care
Caring for the whole person as well as their illnesses. This is often achieved by allowing ‘the story’ to evolve and develop rather than applying a protocol to every situation.
Review an example of a working day in general practice
No typical day. Divided into sessions (half days). Surgeries, Duty Doctor responsibilities, House calls, teaching, managerial tasks, special interest clinics.
Consider personal qualities which may be required in general practice
Caring nature, commitment to high quality care, awareness of ones limitations, ability to seek help, commitment to CPD, appreciation of teamwork, interpersonal and comms skills, clinical competence, organisational ability, ability to manage oneself, ability to deal with uncertainty
Discuss variation between practices
No typical practice. Practices are responsive to local health needs and vary widely. Trends towards larger practices rather than singlehanded rural ones. Practice or building may be owned by the partners or the NHS.
Discuss aspects of running the business of a general practice
GPs are usually independent contractors to the NHS and buy/rent premises and employ staff as a business. Some GPs are employed by GP partners to work as salaried GPs and are paid a fixed salary and do not share in the profits of the practice.
How is IT used in primary care
GP practices are completely paperless.
Uses of IT systems:
- Store appointments
- Book appointments (now online systems for pts)
- Patient records
- Support prescribing
- Storing hospital letters
- Storing test results
- Use in audits
- E-consultations
- Chronic disease management – period followup
- Patient leaflets and resources
- Public health information
- Identify patients for screening
Discuss opportunities for flexible careers in GP, career paths and work/life balance.
GPs as independent contractors have the flexibility to decide the priorities of the practice and their own pattern of work. Many take on other roles such as hospital work and teaching.
GPs can choose how many sessions to work which provides flexibility. Out of hours is opt in.
Discuss postgraduate ongoing learning and reflection
5 year revalidation cycle. Annual appraisal preparation by reading literature, attending courses and performing audits. Ongoing reflection.
State seven occupations in primary care other than a GP.
Practice nurse District nurse Health visitor Midwife Receptionist Medical secretary Pharmacist
What is longtitudinal care
Cradle to grave care. Dealing with acute and chronic care of patients
Discuss aspects of communication in a consultation (communication skills needed, factors influencing the consultation, and consultation styles)
Communication Skills needed
• Content skills: What is communicated
• Perceptual skills: What is being thought and felt, awareness of own biases
• Process skills: How doctors communicate – verbal and nonverbal
Factors influencing the consultation
• Physical Factors o Site and Environment o Adequecy of records o Time constraints o Patient status
• Personal Factors o Age o Sex o Backgrounds and origins o Knowledge and skills o Beliefs
Doctor Patient Relationships
• Paternalistic: Doctor uses all authority and patient feels no autonomy
• Guidance/Cooperation: Doctor still exercises authority but patient has some feeling of autonomy
• Mutual participation: Moderation of use of authority. Patient involved in decision making.
Discuss stress and coping
Stress occurs when the demands of a situation (real or perceived) are greater than the individuals ability (real or perceived) to deal with it using their physical, psychological or social resources.
Signs of stress:
• Cognitive: Anxious thoughts, always seeing the worst
• Emotional (low mood, tension – anxiety and depression)
• Physical: Dizziness, Chest Pain, Ulcers
• Behavioural: Avoiding the stressful situation
Coping is any action taken to alleviated stress. Coping strategies include:
• Problem solving - involving direct action, decision making or planning
• Support seeking – Covering social support, comfort and seeking help
• Escape avoidance – disengagement, denial and wishful thinking
• Distraction – finding alternative activities to do
Discuss why people react differently to illness
Personality and early experience interact to contribute to illness, the course of the disease, and success or treatment. This can be described through two key phenomena:
• The Development of Resilience
• The Development of Attitudes Towards Health
Adult response to illness is a product of a process beginning in childhood.
Illness behaviour is based on social learning:
• Reinforcement: being encouraged to adopt the ‘sick role’
• Modelling: parents showed high illness behaviours
Discuss changing health related behaviour
• Have Information – Information must be:
o Relevant to current goals
o Easily understood and remembered
o Readily available in the moment of decision or action
• Be Motivated – Factors influencing motivation (example alcohol in pregnancy):
o The advantages outweigh the disadvantages (healthy baby)
o Positive response from others to the change in behaviour anticipated (partner wants a healthy baby)
o Social pressure to change (socially unacceptable to drink why pregnant)
o Perceive new behaviour to be consistent with self-image (good mother)
o Belief in ability to carry out the change in a range of circumstances (at home, parties)
• Behaviour Skills – example:
o Assertiveness in negotiating condom use with a sexual partner
What is self-efficacy?
The belief that you can perform a difficult task (eg changing a behaviour)
