Tag Archives: general practice

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Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's currently also Chair of the Jury for the National Research Award of the Swiss College of Primary Care Medicine

 

Swiss primary care research has a very bright future, from what I could see at the early career researchers meeting (TAN HAM) that I attended recently in Bern. Oliver Senn put together a superb programme but the key to its success was the commitment and contribution of the researchers. It was their programme and, not only did they present their work with skill and style, and almost exclusively in English, but each research presentation was chaired by one of their peers as the senior academics looked on from the side lines. The presentations were fantastic, covering a range of topics, as described below. But I thought the peer chaired sessions were an innovation worth replicating at other national and international meetings.

Many countries are struggling to recruit and retain a family medicine workforce and Switzerland is little different. ...continue reading →

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Have we lost something in the success of academic family medicine? We produce quality research, have created successful interdisciplinary academic teams, demonstrate competitive publication outcomes and generate significant grant income. But, academic primary care may have drifted away from, and perhaps even alienated, some family medicine colleagues. There are thoughtful and reflective family doctors who read, write, discuss and debate many aspects of general practice but feel undervalued as they do not fit the university based academic profile. ...continue reading →

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Was I wrong!

Pioneering Professional Practice doesn’t sound like the most stimulating title of a Plenary Address but Helen Stokes-Lampard, Chair of the UK's Royal College of General Practitioners (RCGP) Council, gave an uplifting, encouraging and inspiring address on the topic on day 2 of the SAPC ASM 2017. Helen encouraged us all to rediscover the joy and sparkle of general practice despite poor morale, a constant feeling of being under siege, and increasing resource limitations in the profession. I liked her analogy that primary care, secondary care and social care were interdependent and need to be together- a three legged stool that depended on all three components to remain stable. ...continue reading →

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Shakespeare’s Warwickshire was the background to last week's 46th Annual Scientific Meeting of the Society of Academic Primary Care (SAPC) where Professor Christine Ennew, Provost of the University of Warwick, introduced the meeting by emphasising the importance of primary care in the development of their young medical school. She also underlined her belief in the transformational power of universities and how their contribution to academic medicine can alter clinical practice.

It saddened me that her optimism and enthusiasm contrasted with the stark reality of general practice as outlined by Candace Imison, Director of Policy at the Nuffield Trust ...continue reading →

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C_LaddCarrie Ladd is a part time general practitioner in the UK National Health Service, a spare time RCGP Clinical Fellow in Perinatal Mental Health, and a full time mum…doing overtime!

 

Despite all the pressures, challenges and daily frustrations of working in the NHS, I still feel being a General Practitioner in the UK is the best job in the world. Well, second best to being a mum to my incredibly fun and loving two young children. But which role is truly the more challenging? Those who have children will know instantly what I am talking about and those without may well know from friends that this question has serious ground for debate. Despite 13 years of further professional development in the form of continued education, assessment and appraisal since leaving Southampton Medical School, there are many difficult moments I deal with as a mum where I feel as unsure and inexperienced as any other parent. People often generously assume that of all health professionals, medics in particular will know what to feed their fussy baby, how to discipline their child in front of the grandparents and what to do when their “spirited” toddler throws a tantrum in a supermarket. I write to correct this misconception. ...continue reading →

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DenisSir Denis Pereira Gray, OBE, is a consultant at St Leonard’s Research Practice, Exeter, and Emeritus Professor at the University of Exeter in the United Kingdom

 

A few weeks ago a blog by Domhnall MacAuley picked up on an article that I had written in the British Journal of General Practice, entitled “Academic general practice: a viewpoint on achievements and challenges.” The article was written to ask some big questions and to stimulate debate about academic general practice and Domhnall's blog followed it up interestingly and extended the issues.

I am still optimistic about academic general practice. General practice is the key branch of the medical profession and there are still many aspects of it to be discovered. Yes of course “big data” are a new resource and need new techniques, but a place remains for clinical research in general practice and in single research active general practices too. However, the relationships and the support for research in clinical settings need clarification and funding. The prime role of single practice research is to study new clinical developments, to scope their potential, and pave the way for bigger definitive studies.   Single practices do have the numbers for statistical significance if they choose their subject ...continue reading →

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Bruce Arroll is a Professor of General Practice at the University of Auckland and a GP at the Greenstone Family Clinic in Manurewa Auckland

 

My first clinical impression of primary care was of lots of symptom clusters that did not appear in Harrisons Textbook of Medicine. These symptoms would fluctuate and I would investigate some and often find no satisfactory answers from my investigations and referrals. I gradually learned to use time as my diagnostic test and some of these symptoms would disappear while others would stay. Many of them did not follow any anatomical or physiological pattern. I now prefer the term illness without disease1 as Medically Unexplained Symptoms (MUS) sounds like if you did just one more (or the right) scan/xray/referal/consultation you'd find the answer. There was a qualitative study on what patients liked when they had MUS. Their preference was for some sort of explanation ...continue reading →

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DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Reading a recent robust critique of the achievements and challenges to academic general practice in the UK, and a plea by senior academics for increased capacity in clinical academic general practice, I began to wonder.... How might we design general practice research for the future, what direction should a department of general practice take, and where does general practice fit into the future of clinical research? As an intellectual exercise, I allowed myself to think the unthinkable. And, for a general practice academic, brought up in family medicine and immersed in the traditions of personal primary and continuing care, this felt like heresy. At the very least, however, perhaps we should begin to think creatively about the future. What do you think?

It is difficult to see a future for academic general practice. ...continue reading →

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Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's giving the opening keynote address at the upcoming Swiss Family Doctors Conference 2015 in Bern, which focuses on core competencies in family medicine.

 

What is a family physician?

Many colleges and organisations have tried to define the core competencies of general practice. These include the College of Family Physicians of Canada, the Royal College of General Practitioners in the UK, and WONCA Europe with their definition of general practice /family medicine and the revised WONCA tree illustrating the core competencies and characteristics. Defining the role of the family doctor is difficult ...continue reading →

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Jane Gunn oct 2010Jane Gunn is Chair of Primary Care Research and Head of the Department of General Practice at the University of Melbourne, Australia

Primary care in Australia

What do populations need?

Populations need a fair health care system that reduces the current inequities seen in the health of the population. Australia needs a health care system that focuses on prevention in addition to treatment and care. In particular, we need to improve the health of Aboriginal and Torres Strait Islander people. Populations deserve a strong primary health care system in the community for "first contact" care that builds upon the strengths of existing general practice. ...continue reading →