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This collection of essays on general practice, written by a variety of eminent contributors working in primary care, considers the influence and leadership of GPs and general practice in the wider community in order to improve the understanding of general practice.
Primary care, grounded in the provision of continuous comprehensive person-centred care, is of paramount importance in the delivery of accessible and effective health care around the world. The central notion of person-centred care, however, relies on often-unexamined concepts of self, or understandings of what it means to be a person and an agent. This cutting-edge book explores contemporary pressures on the sense of self for both patient and health professional within a consultation and argues that building new concepts of the self is essential if we are to reinvigorate the central tenets of person-centred primary care. Contemporary trends such as shared decision-making between health professionals and patients and promoting self-management assume those involved are able to make their own decisions and take action. In practice, however, medicine often opts for reductionist perspectives of patients as passive mechanical systems and diseases as puzzles. At the same time, huge political and organisational changes mean time and resources are scarce, putting further pressure on consultations. This book discusses how we can start to resolve these tensions. The first part considers problems posed by the increasing bureaucratisation of primary care, the impact of information technology in the consultation, the effects of chronic disease on our sense of self and how an emphasis on biology over biography leads to over-diagnosis. The second part proposes solutions based on a strong ontology of consciousness, concepts of creative capacity, coherence and engagement, and will show how these can enhance the self-esteem of patients and doctors and benefit their therapeutic dialogue. Combining theoretical perspectives from philosophy, sociology and healthcare research with insights drawn from clinical practice, this edited volume is suitable for those researching and studying primary healthcare, communication and relationships in healthcare and the medical humanities.
Good Practice: What it means to put the patient first, not politics, posturing, pretentiousness, protocols or process. This is a text book for all doctors but especially GPs, Appraisers and Registrars. It is written by a 40 year plus front line NHS doctor who for most of his career worked twice to three times the current doctors’ Working Time Directive limited week. Chris Heath has been a Paediatric Lecturer in a teaching hospital, an Anaesthetist, various junior specialists and a GP for over 30 years in 3 different practices. He has been a GP Trainer and Appraiser and has seen politics and political correctness harm patients’ interests constantly over the last half of his career. From the way the NHS selects young doctors to the way they are educated and assessed, the best interests of the patient are largely ignored. This is a text book but it also contains home truths, advice, insights and original, honest guidance on being a safe, effective doctor. As well as giving an assessment of what has gone wrong with the NHS over the last 20 years, the author explains why today’s politicians, medical schools, Royal Colleges and many doctors will resist the changes essential to put the patients’ needs first again. 1 Politics, Who we are, The CQC etc 2 Administration, Training, The Consultation and Teaching 3 Basic Biology 4 Acute Medicine in General Practice 5 Alcohol 6 Allergy 7 Analgesics 8 Anticoagulants, Clotting 9 The Breast 10 Cancer and Terminal Care 11 Cardiology 12 Useful Clinical Signs, Eponymous diseases 13 Dermatology 14 Diabetes, Metabolism 15 Diet, Vitamins and Nutrition 16 Driving 17 Odd drugs 18 Ear, Nose and Throat 19 Gastroenterology 20 Geriatrics 21 Haematology 22 Hormones 23 Immunisation and Vaccines 24 Infections, Antibiotics, Microbiota 25 Legal Issues 26 Liver 27 Miscellaneous 28 Musculoskeletal, Orthopaedics, Sports, NSAIDs 29 Neurology 30 Ophthalmology 31 Paediatrics 32 Pathology 33 Pregnancy, Obstetrics and Gynaecology, Contraception 34 Psychiatry and Controlled Drugs 35 Respiratory 36 Sex and STDs 37 Sleep 38 Travel 39 Urology 40 Work References
This is a text book for all doctors but especially GPs, appraisers and registrars. It is written by a 40 year plus front line NHS doctor who for most of his career worked twice to three times the current doctors’ Working Time Directive limited week. Chris Heath has been a Paediatric Lecturer in a teaching hospital, an Anaesthetist, various junior specialists and a GP over 30 years in 3 different practices. He has been a GP Trainer and Appraiser and has seen politics and political correctness harm patients’ interests constantly over the last half of his career. From the way it selects young doctors to the way they are educated and assessed, the best interests of the patient are largely ignored. This is a text book but it also contains home truths, insights and a warts and all appraisal of how to be a good doctor as well as an unbiased assessment of what is wrong with today’s NHS. It also explains why today’s politicians, medical schools and doctors will resist the changes that are needed to put the patients’ needs first again.
Compassion takes as its starting point 'Cum scientia caritas', the motto of the Royal College of General Practitioners. Translated as 'Science with compassion', it captures the technical and caring aspects of being a doctor. Science is continually developing but compassion is unchanging. But how relevant is compassion to the NHS today? Compassion is central to the practice of health care. Patients require compassion as much as they require knowledge and technical skill from their healthcare professionals. Compassion should be a motivation for anyone choosing a career in primary care. However, in recent years there have been startling instances where compassion has not been shown. Compassion: Compassion, Continuity and Caring in the NHS is a reminder that compassion is at the heart of good medical practice. The book is split into sections on patients, education and training, clinicians and future developments. There are overview chapters on access to health care, the changing model of NHS care, a history of GP selection procedures and ways of preparing the next generation of GPs. This wide-ranging book also contains chapters on specific topics: the role of the multidisciplinary team, homeless patients, prescribing, nursing in primary care, post-conflict symptoms, suicide prevention and more. Personal perspectives are also given: A layman provides a personal account of the end-of-life care his wife received. A junior doctor reflects on the different factors that guide compassion. And a doctor from the United States offers a worrying picture of primary health care's possible fate. This book looks to the future too with chapters on scholarship, building resilience, mindfulness, continuity of care and the development of a new professionalism. This book will help the reader reconsider and re-evaluate compassion - the characteristic so important in creating a long-term relationship between health professional and patient.
Looks at a wide range of important general practice issues relating to professional and practice development and quality improvement, under the broad themes of teaching, learning and leadership.
This accessible text covers the entirety of General Practice and the General Practitioner, from student to retirement and from the beginning of the NHS to the present day. It provides a comprehensive historical overview representing both academic and front-line perspectives, describing what has changed, beneficial or otherwise, as the specialty has evolved. The details within each chapter represent the views of the average working British GP and illustrate how the changes over the decades have impacted patient care and its delivery. The perspective often differs from that which prevails in many academic tomes on the subject. The topics covered, from the primary care team, changes to out-of-hours provision, the impact of IT, training, and regulation, to the future of General Practice, will be essential reading for all doctors considering a career in the specialty and will also be of interest to GP vocational training scheme course organisers and trainers, overseas medical educators and healthcare policy makers, social and medical historians, and the general public.
This unique work represents the recording and analysis of oral history interviews conducted by the pioneering general practitioner Dr Hetty Ockrim with over seventy patients, as well as office staff and members of the nursing team, between 1989 and 1992 in her former practice in the Ibrox/Govan areas of Glasgow, places of significant socio-economic deprivation. Her focus in undertaking this study was on personal and social, rather than just clinical, issues. The interviews are accompanied by background and commentary for the study, reflecting the full breadth of general practice. Many of the interviewees had memories stretching back before the NHS, providing a unique historical perspective of service development, as well as invaluable directions for improving current and future general practice. Key Features Provides a historical context for the developments in health over several decades prior to the study Shows how oral history methods have increasingly been used in medical history research and explores the benefits of this approach Covers many of the themes of the oral history which enabled and encouraged patients to comment on what was important to them in their encounters with health care Follows the increasing acceptance of women in medicine, demonstrating how women doctors were viewed by patients within the practice compared to changes in wider society Presents a ‘history from below’, using voices that are not normally heard in the medical discourse, illustrating the importance of the doctor–patient interface Supporting a wider understanding of what patient narratives can tell us about the delivery of health care from the perspective of the patients, the front-line users of health services, the book show how oral history can provide an understanding of health care more broadly, key at a time when social inequality is once again widening in many regions.
Advances in Family Practice Nursing is a yearly publication aimed at family practice nurse practitioners and brings you the best current clinical information from the expert editors and authors in pediatrics, adult/gerontology, women's health, and primary care in general. Whether you're looking to update your knowledge of a particular area or to read about the newest clinical advances to incorporate into your clinical care, this publication aims to appeal to all nurse practitioners providing primary care to patients. This current edition touches on issues like mental health issues in children and adolescents during the COVID 19 pandemic, COVID in older adults, coexisting depression and anxiety in pediatric primary care, and uterine and bladder prolapse assessment, to name a few.