Year 1 Flashcards
WHO definition of health
“A state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity.”
What are the types of questions used in a consultation
Open ended Direct Closed Leading Reflected
What is an open question
Is not seeking a particular answer but simply signals the patient to tell his story
What is a direct question
Ask about a specific item
What is a closed question
Can only be answered with yes or no
What is a leading question
Presumes the answer
Is best avoided
What is a reflected question
Allows the doctor to avoid answering a question
Example of open question
Tell me about the pain
Example of direct question
Where is the pain
Example of closed question
Is the pain severe
Example of leading question
The pain is severe?
Example of reflected question
You want to know the cause of the pai
Which 3 styles of doctor patient relationships has Szasz and Hollender describes
Authoritarian or Paternalistic
Guidance/co-operation
Mutual Participation
How long does an average GP consultation take
10 mins
What 3 separate activities does a consultation typically involve
- Talking together (always)
- Doctor examining patient (often)
- Performing Procedures (sometimes)
Culturally what is described as normal
What is defined as normal will depend on expectations and standards of the society
Thus on political, economic and social factors
Criteria may differ between societies, over time within the same society, and between groups within the same society
Which factors can determine expectations and standards of normal culturally
Political
Economic
Social factors
Describe a mutual participation relationship
Active involvement of patients as more equal partners
What is the lay age belief about health
Older people concentrates on functional ability in their daily lives
Younger people tend to speak of health in terms of physical strength and fitness
What is the lay social class belief about health
People living in difficult economic and social circumstances regard health as functional – the ability to be productive, to cope and take care of others
Women of a higher social class or educational qualifications have a more multidimensional view of health
What is the gender lay belief about heath
Men and women appear to think about health differently
Women may find the concept of health more interesting
More likely to attend their GP
Women include a social aspect to health
Men tend to leave their health to get worse for longer
What is the training path to becoming a GP
5yrs med school FY1 and 2 GP 3yrs training path - 2yrs hospital training - 1yr GP training
Who is the first point of contact for patients needing to see a doctor
GP
Which wide range of skills do GPs need to have
Problem solving Managing risk and uncertainty Evidence based medicine Wide range clinical skills Holistic approach aimed at managing risk and dealing with uncertainty and complexity
Who can GP practices be owned by
GP themselves
Or Local NHS organisations
What is the trend in types of practices
Tend to be large primary health care centres now
Which aspected of lifestyle may be covered in a GP consultation
Diet Exercise Alcohol Smoking Illicit Drug Use Sexual Health
What are the used of computers in GP practices
Online transactions Appointment booking Repeat prescriptions Support prescribing Assist in consultations Allow GPs to manage hospital letters Allow GPs to manage blood results Keeping records (digital record keeping)
Do GPs own and run businesses by themselves or in partnership with others
Can be either
What is a GP running the business responsible for
Providing:
Adequate premises and infrastructure
To provide safe patient services and employ/train practice staff
Advantages of using technology in GP practices
Patient data can be easily accessed by any approved member of staff at any time and sometimes any place when working remotely
Patient data can be listed, graphed and searched easily (enabling GPs to convey and track information)
How often do GPs need to revalidate their qualifications
Every 5yrs
How do GPs prepare for appraisal
Reading literature
Attending courses
Performing audits
Who composes the practice team
Manager IT/Admin Staff Secretarial Staff Reception Staff Nurses- Junior/Senior Advanced Nurse Practitioners/Physicians Assistants Phlebotomists/Health Care Assistants
What is a major key attraction of GP
Ability to be flexible and make own decisions about the balance of their team to address the needs of their own practice
What are options within GP
Partner Special interest (e.g Obs & Gynae, Diabetes, Minor Surgery) Salaried GP Part time (3 days rather than 5) Medical education Sports doctors
Are GPs now required to work out of hours
No
No longer required
What is meant by longitudinal care
Possibility to work with someone from birth right through to adult life
What does effective communication improve?
Patient satisfaction Patient recall Patient understanding Patient concordance And outcomes of care
Which 3 broad types of skills are needed for successful medical interviewing
Content skills
Perceptual skills
Process skills
What can body language include
Gaze behaviour
Posture
Specific gestures
Which factors influence the consultation
Physical factors
Personal factors
- doctor
- patient
What are Roger Neighbours tasks in a consultation
Connect with the patient
Summarise and verbally check that reasons for their attendance are clear
Hand over and bring the consultation to a close i.e hand over to the patient a the end to ensure all issues have been covered
Ensure safety net exists in that no serious possibilities have been missed
To deal with housekeeping of recovery and reflection
