Aust Fam Physician
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Fibromyalgia is a chronic musculoskeletal disorder that is characterised by widespread pain, tenderness at multiple anatomical sites and other clinical manifestations such as fatigue and sleep disturbance. It occurs predominantly in women and affects approximately 2-4% of people in industrialised societies. ⋯ Fibromyalgia is a disorder of pain amplification due to increased sensitivity of the pain system. Management of simple fibromyalgia involves education regarding the nature of the problem, an exercise program and advice on stress management. However, management needs to be flexible and holistic and may involve relaxation programs, physical therapies, cognitive behavioural therapy and analgesic medication.
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The overall aim of the study was to examine the quality of communication and the amount of patient information conveyed by general practitioners when referring patients to an emergency department. The study also looked at the prior use of telephone calls made by the referring doctors and ambulance usage for patients referred with a provisional diagnosis of acute coronary or cerebral event. ⋯ For those patients who did present with a referral letter, the standard of information lacked consistency and there was a difference between the content of letter written by their usual GP as opposed to another GP. This study found there was infrequent telephone communication when patients were referred by their GP to the emergency department. This study also shows an under-utilisation of the ambulance service by GPs in south west Sydney when referring patients with coronary ischaemia or a cerebral event to the emergency department.
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The rapid development of the internet means that both a wealth of health information and a minefield of misinformation are now available to our patients. No longer are medical practitioners seen as the sole custodians of medical information. ⋯ Do you believe that the internet will have an impact on your clinical practice? Can you see yourself conducting teleconsultations at a distance with your patients in the future? Will you be using e-mail to send results to your patients and to recall them for preventive care interventions? Will you and your patients be surfing the internet together for the answers to clinical dilemmas? The future may be closer than you think.