The British journal of general practice : the journal of the Royal College of General Practitioners
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For nurse practitioners (NPs) in general practice to substitute for general practitioners (GPs) in consultations, their educational needs require specification, and their effectiveness and acceptability to patients must be determined. There is limited evidence in the United Kingdom about training requirements or how NPs compare with GPs. ⋯ Early in their training, TNPs made good diagnostic and treatment decisions, while their high level of patient transfers to GPs indicated residual uncertainty. In independent practice, their GP mentors judged them to be offering an effective service, with acceptable transfer and patient return rates. They were liked by patients and more so by patients with previous TNP experience. TNPs are a valuable substitute for GPs for patients wishing for a same-day consultation, and for younger and female patients who prefer a female TNP over a male GP. Limited authority to prescribe and refer to secondary care reduces NP efficiency.
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There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. ⋯ Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments.
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Colour is often used as a sign in medicine, yet there have been few studies into the effects of a colour vision deficiency (CVD) on doctors' medical skills. Using a literature search, the results indicate the prevalence of CVD in the medical profession and its effects on medical skills. For the congenital form among male doctors in the United Kingdom, the prevalence is shown to be probably about the same as for the population at large; i.e. 8%. ⋯ The effect on skills is also shown. Because of certain features of their work, general practitioners may have special problems. Thus, it is concluded that medical students and doctors should be screened for the deficiency and advised about it, and that there should be more study of the effects of CVD on decision-making in general practice and some specialties.
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Colour vision deficiency (CVD) is a common anomaly, especially in the male population. A group of doctors with CVD was compared with a control group. Doctors with CVD differed from controls in respect of their ability to detect, and in their confidence in the assessment of, abnormalities presented in clinical photographs. These findings suggest that doctors with CVD should take special care to ensure safe clinical practice.
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Randomized Controlled Trial Clinical Trial
Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care.
The need for closer coordination between primary care medical and dental services has been recognized. ⋯ Both professionals and patients have reasonably positive attitudes towards the use of patient-held records. Among patients, the experience of having the integrated medical-dental PHR led to greater enthusiasm towards the idea. Dentists in particular would benefit from the transfer of information from doctors, but better methods are needed to ensure that patients take the integrated medical-dental PHR with them. Given the current lack of ability to easily produce an integrated medical-dental PHR, further examination of the routine issue of a copy of their medical summary, by GMPs, to all patients would be worthwhile.