Family practice
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In a study in Sweden of 160 consultations, general practitioners and patients separately assessed their satisfaction with the consultation length and the ability of the patient to explain the problem. These assessments were compared with each other and were correlated with the actual length of the consultation. The mean length of the consultations was 21 minutes with a great variation between different doctors. ⋯ The patients were on the whole more satisfied than the doctors. There was no evidence that longer consultations gave more satisfaction for either doctors or patients. The doctors not only registered more psychological problems than the patients but they were more likely to register insufficient time for discussing psychological problems.
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The discussions are led by a psychoanalyst, or someone in touch with the approach fostered by psychoanalysis, and the group is helped to develop an atmosphere of tolerance and safety. Participants are thus able to discuss cases that represent the personal difficulties they are currently experiencing in their daily work. This report is about one group whose members agreed to allow the process of their work to be studied. ⋯ It also describes methods used to assess the quality of learning and the changes in personal attitudes. A Balint group has a safe and defined mode of working but no specific agenda, save that provided by the personal cases presented by those who come regularly to its sessions. This study aims to describe the kind of experience such a group can offer to intending participants.
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Most clinical research in the United States has been carried out in atypical populations. This study, done in a network of primary care populations in Virginia, calculates the denominator by the utilization correction factor method and compares the demography with that of the population of the state. The demographic characteristics of the patients in the network are very similar to those of the underlying populations and on the same order of state-of-the-art sampling methods in current use.
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There is little evidence of any association, either positive or negative, between the occurrence of depression and other clinical conditions. It would be particularly useful in general practice to identify any positive association between depression and other illness as this would make depression less likely to be missed in the consultation. Morbidity data recorded in the UK second national morbidity study were analysed, attention being confined to patients aged 45 years and over, who would be more likely to be suffering from chronic illness. ⋯ Morbidity codings were analysed to discover whether any of these conditions was recorded more or less frequently than might have happened by chance in the depressed group. Examples of conditions both positively and negatively associated with depression were revealed, the former being the more highly significant statistically. Validation of these findings should be sought in a similar analysis of the data from the UK third national morbidity survey, soon to be published.