ABSTRACT: BACKGROUND: Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case ...

Epididymo-orchitis is a common urological presentation in men but recent incidence data are lacking. Guidelines for management recommend detailed investigation and treatment for sexually transmitted pathogens, such as Chlamydia trachomatis. Data from secondary care indicate that these guidelines are poorly followed. It is not known how epididymo-orchitis is managed in ...

In the general practice setting it is inevitable that practice owners and managers will need to deal with staffing problems. As well as making sure work gets done according to the expected standards, there are legal issues in the way practice staff are managed and problems addressed. This article is ...

The translation of molecular medicine into clinical practice has implications for general practice and personalised medicine. This article outlines requirements for general practice to make optimal use of genomics. Genomics identifies variations in many genes, enhancing knowledge of gene-gene and gene-environment interactions. Unlike personal information, genomic information raises issues of ...

Genitourinary Chlamydia trachomatis infection is common and associated with considerable personal and public health cost. Effective detection strategies are needed. To assess feasibility of an opportunistic incentivised chlamydia screening programme in general practice over six months. This study was designed as a pilot for a randomised controlled trial in primary ...

Leadership in a general practice is diverse and frequently subtle. Most leadership models have been developed around large organisations, military or government. These models do not transpose easily to a general practice. This article looks at some of the opportunities to give leadership in a practice. It is based on ...

General practice is a business. Most practices can stay afloat by having appointments, billing patients, managing the administration processes and working long hours. What distinguishes the high performance organisation from the average organisation is a business plan. This article examines how to create a simple business plan that can be ...

To validate the Professional Practice Environment Scale (PPE) in Australian general practice. The PPE was modified slightly for appropriateness for the practice setting and administered to a sample of 342 Australian general practice nurses via an online survey tool. The factor structure of the 38-item PPE was examined using principal ...

Setting up a new practice, or starting in an existing practice, is a major decision. Becoming a practice owner needs careful consideration. This article looks at some of the aspects involved in starting a practice. Like previous articles in this series, it is based on The Royal Australian College of ...

OBJECTIVE: To assess the views, needs and intended behaviour of general practitioners and practice nurses (PNs) regarding pandemic influenza. DESIGN, SETTING AND PARTICIPANTS: A postal survey of GPs and PNs in four Divisions of General Practice in New South Wales, selected to represent a diverse sample of practices from inner-city, ...

Medicine involves specific practical expertise as well as more general context-independent medical knowledge. This raises the question, what is the nature of the expertise involved? Is there a model of clinical judgement or understanding that can accommodate both elements? This paper begins with a summary of a published account of ...

More than most small businesses, medical practices require good governance. One of the qualities most expected of a family doctor is trust. This encompasses not just doing the right thing by patients but also our colleagues, employees, business partners and the community. In this article, we reflect on some of ...

BACKGROUND: There is low uptake of chlamydia screening in general practices registered with the English National Chlamydia Screening Programme (NCSP). Aims. To explore staff's attitudes and behaviour around chlamydia screening and how screening could be optimized in general practice. METHODS: A qualitative study with focus groups and interviews, in general ...

Immunisation coverage in New Zealand is lower than what is necessary to prevent large epidemics of pertussis. Primary care is where most immunisation delivery occurs. General practices vary in their structure and organisation, both in a general sense and specifically with respect to immunisation delivery. To identify the structural and ...

BACKGROUND: United Kingdom general practitioners receive payment based on their performance in multiple clinical indicators. We set out to apply the same indicators in an Australian general practice to benchmark our performance and to see how much work was required to obtain the data. METHODS: Clinical indicators for the 2008-2009 ...

Little is known about the incidence, prevalence, and impact of patient-initiated aggression against general practice staff in Australia or how medically related professional organisations respond to this. The few available Australian studies suggest that up to about two-thirds of Australian GPs experience patient-initiated aggression within a 12-month period. This paper ...

BACKGROUND: The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of ...

OBJECTIVES: To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. DESIGN: A case study method was used in a Kent ...

In recent years, there has been growing interest in the role of primary care in postgraduate training. Relatively little has been published about benefits of early and sustained postgraduate basic training in general practice, especially for doctors with other ambitions than family medicine. To explore young Danish doctors' views on ...

Upper limb extremity rehabilitation practices are increasingly involving robotic interaction for repetitive practice, and there is increasing skepticism whether such systems can provide the relevant practice that can be generalized (or transferred) to functional activities in the real world. Most importantly, will patients be able to generalize in three critical ...

BACKGROUND: The Royal Australian College of General Practitioners Guidelines for preventive activities in general practice (the 'red book') are now more than 20 years old. Therefore it is an important juncture to reflect on their appropriateness and implementation, and how they can be improved in future editions. OBJECTIVE: This review ...

BACKGROUND: Recruitment to trials in primary care is often difficult, particularly when practice staff need to identify study participants with acute conditions during consultations. The Scottish Acute Recruitment Management Application (SARMA) system is linked to general practice electronic medical record (EMR) systems and is designed to provide recruitment support to ...

The generic medicines market in Australia is continuously growing and there is a push by the government towards generic substitution. However, generic dispensing places additional time constraints on pharmacists. There is also an increased need for professional judgement, and hence increased risk of error. Generic dispensing consequently places an increased ...

At the onset of a mild Victorian winter, four enthusiastic, fresh faced Irish general practice registrars made their way to Australia on an academic and cultural exchange. As registrars in the final throws of our fourth year general practice training in Donegal, we swapped the rugged, windswept northwest coast of ...

The Australian Government will provide $275 million over 4 years to general practice infrastructure across Australia with the rollout of 31 General Practice Super Clinics. One of the core objectives of these Super Clinics is to support medical education. Several studies have demonstrated that the major barriers to teaching in ...

So far, the chances for tobacco prevention are not currently implemented sufficiently in general practices. The involvement of practice nurses (PN) could contribute to reach more patients. This study investigated the characteristics of PN which could be relevant for the implementation of counselling offers. A total of 216 general practices ...

BACKGROUND: In contrast to generally high childhood immunisation coverage rates across Australia, general practices in central Sydney (New South Wales) have a below average coverage rate. To address this, Central Sydney GP Network undertook a project that involved visiting practices with less than 90% coverage and provided guidance and support ...

SETTING: Sudden Cardiac Death accounts for approximately 5000 deaths in Ireland each year. Nationally, out-of-hospital cardiac arrest has a very low resuscitation rate, reported at less than 5%. Ireland has a well developed general practice network which routinely manages emergencies arising in the community setting. However, little is known about ...

OBJECTIVE: To ascertain the teaching load of general practices, the capacity for expansion of general practice-based teaching and the support required to achieve this. DESIGN, SETTING AND PARTICIPANTS: Questionnaire-based survey of general practitioners and practices who were teaching medical students, junior doctors or GP registrars in partnership with the Adelaide ...

BACKGROUND: Pneumonia is a common diagnosis in general practice in the United Kingdom and yet there is little known about the short- and long-term prognosis of people with a diagnosis of pneumonia in general practice. We investigated the short- and long-term survival of people with pneumonia diagnosed in general practice ...

BACKGROUND: Chalazia, or meibomian cysts, are often seen in general practice. While most can be resolved with a minor operation in a designated procedure room, there is a lack of published literature on the details of the incision and curettage used to treat this condition. OBJECTIVE: This article outlines the ...

BACKGROUND: For many years, the Heart Foundation has been involved in the development of evidence based clinical practice guidelines for the management of cardiovascular diseases and conditions, including coronary heart disease (CHD). However, the production of guidelines does not ensure the uptake of evidence based recommendations in practice. This 'management ...

BACKGROUND: There is currently a shortage of general practitioners and an increase in the number of medical students and general practice trainees. The expanded involvement of general practice registrars in teaching roles has been suggested as part of the solution to increasing the number of teaching roles in general practice. ...

BACKGROUND: An accurate diabetes register enables a general practice to effectively monitor and manage the services for their patients with diabetes. This pilot project builds on the National Primary Care Collaboratives Program (a quality improvement programme for general practice) as the first change principle for managing chronic diseases. OBJECTIVES: The ...

BACKGROUND: Patients' health related quality of life (HRQoL) has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i) the ...

General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. ...

Although there is evidence for the effectiveness of self-management support, there has been limited engagement of Australian general practice staff with self-management support provided by other services. Efforts to integrate self-management support into general practice have also been challenging, largely because of capacity constraints and the difficulties of incorporating it ...

BACKGROUND: There is limited evidence regarding the factors that facilitate recruitment and retention of general practices in clinical trials. It is therefore pertinent to consider the factors that facilitate research in primary care. AIM: To formulate hypotheses about effective ways of recruiting and retaining practices to clinical trials, based on ...

BACKGROUND: The shortage of general practitioners in Australia is likely to continue unless more doctors choose general practice as a career. The aim of this qualitative research was to explore the factors that influence students' and junior doctors' career choice, particularly in respect to choosing general practice. METHODS: Medical students, ...

The author defines the essential management skills that are unique to building a successful hair restoration surgery team and contrasts these skills with those needed to manage a general cosmetic surgery practice. Strategies for hair technician selection, training, supervision, and management are discussed, emphasizing the management skill areas that are ...

BACKGROUND: We wanted to study how female general surgeons in Canada manage lifestyle and career demands. METHODS: All female Canadian general surgeons registered with the Royal College of Physicians and Surgeons of Canada were asked to complete a survey evaluating their practice patterns, personal lives, and levels of satisfaction related ...

Over the past 3 years Gippsland Education and Training for General Practice (getGP) has piloted the Irish Registrar Exchange Program, offering general practice registrars the opportunity to spend 3 months of their general practice training in rural Ireland, and similarly hosting visits from Irish registrars. The visits occurred toward the ...

OBJECTIVES: The present study aims to investigate (1) what is the influence of illness labels (flu, asthma and angina pectoris) upon the level of agreement with the prescription of generic medicines, and (2) the influence of socio-demographic factors on lay beliefs about generic medicines, in general, and for different illness ...

To establish the association between sheep farm management practices and cryptosporidiosis in Central Mexico, 37 farms were invited and questionnaires answered by owners. Faeces samples were taken from lambs under 3 months old and ewes in the farms. Parasites were identified by modified Ziehl-Neelsen stain. Questionnaire included: general farm information, ...

There is an ongoing shortage of general practitioners in Australia, accompanied by a decline in the popularity of general practice as a career choice. Many factors influence the career choice of junior doctors and medical students, including role models, the quality of clinical attachments during training, remuneration, and flexibility of ...

BACKGROUND: In 2001, a white paper set out a commitment to ensure that people with a learning disability receive equal access to health services, with an expectation that general practices would have identified all people with a learning disability registered with the practice by June 2004. AIM: To outline the ...

BACKGROUND: Despite the fall in MMR uptake between 1998 and 2004, some general practices managed to sustain remarkably high MMR coverage. METHODS: The aim of the study was to identify general practice factors associated with high MMR vaccine coverage. The study population included 257 general practices in Cumbria and Lancashire ...

Substitution of branded medicines by cheaper generic medicines has been and is subject for debate in the Netherlands. One of the tasks of the Dutch Medicines Evaluation Board (CBG) is the evaluation of generic medicines. The way the CBG approves generics, as outlined in this paper, is based on assessment ...

BACKGROUND: Efforts to improve the quality of healthcare for patients with chronic conditions have resulted in growing evidence supporting the inclusion of patient empowerment as a key ingredient of care. In 2002, WONCA Europe issued the European Definition of General Practice/Family Medicine, which is currently considered the point of reference ...

During the development of The Royal Australian College of General Practitioners Standards for general practices (3rd edition) in 2005, the unflagged (nonessential) indicator 'the practice has a defibrillator' was tested in a survey of 200 practices Australia wide. Defibrillators were present in 18% of these general practices: 20.5% of surveyed ...