Aust Fam Physician
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General practitioners are concerned with improving the health of the community, and Divisions are an important structure through which this can be achieved. Any focus on health outcomes needs to consider what general practice and Divisions can do to reduce inequalities in health outcomes. ⋯ Divisions see socioeconomic disadvantage as an important issue, and some are developing significant multilevel strategies to address them, although significant gaps exist in the capacity of Divisions to undertake this work.
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The Rural Faculty of The Royal Australian College of General Practitioners (RACGP) has received funding from the Commonwealth Department of Health and Ageing to work in partnership with the National Aboriginal Community Controlled Health Organisation (NACCHO) and other key organisations in supporting the professional and personal needs of GPs and general practice registrars working in Aboriginal and Torres Strait Islander health throughout Australia. ⋯ While the improved resources and access to training and support resulting from this work will benefit many GPs and general practice registrars, there is urgent need to continue to support GPs in order to address problems of recruitment and retention of doctors working in Aboriginal health and thus assist in improving the health status of Aboriginal and Torres Strait Islander peoples.
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Diabetes, heart disease and other vascular diseases are a great problem in Aboriginal communities and there are many reasons for this. As a health professional it is easy to feel overwhelmed by both the magnitude of the problem and the feeling that it is just too hard when patients don't seem to take charge of their own health. ⋯ To improve health outcomes we need to focus on two parts of the same problem. First, we need to tackle the vascular diseases at their roots--the vascular risk factors. Second, we need to look at ways to promote self management so that our patients can identify personal barriers to self care and be partners in their health care. There is evidence that better organised systems of care, such as recall systems and improved screening systems, are very beneficial. The most successful interventions are culturally appropriate and developed and implemented with Aboriginal community control.
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It is generally accepted that adherence or compliance to medical therapy can be poor in indigenous Australian communities. ⋯ First, the importance of gaining trust and credibility with a community is discussed. Approaches to gain that trust are then described. It is critical to overcome the considerable language and world view barriers that exist to good communication. The use of anatomical models and high quality illustrations combined with the development of 'key language concept' in the indigenous language have achieved some success in this area.