Aust Fam Physician
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Clinical handover and obtaining best possible medication histories (BPMH) at transition points in care are key patient safety pri-orities. This study aimed to determine the accuracy of medication histories documented on general practitioner (GP) referral letters for patients referred to emergency departments. ⋯ Of the GP letters (total 414), 361 (87%) had one or more discrepancies in the patients' regular medications and 62% had one or more regular medication discrepancies of moderate-high significance. Omission of medication was more prevalent in hand-written letters (P DISCUSSION: GP referral letters should not be used in isolation to determine the medication regimen taken before an emergency department presentation. Interventions are indicated to improve awareness and accuracy of medication documentation.
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Support for generalism is underpinned by more than 100 years of writings and these writings point to writers and thinkers who have grappled with the tensions between generalism and specialism since ancient Egyptian times. Taking a historical stance we make the case that generalism is here to stay. But, what does the future hold? We outline some ideas for growing generalism in the wake of smart technologies, personalised medicine and the deluge of ever increasing health information.
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There is concern from within Aboriginal and Torres Strait Islander communities about the lack of access to alcohol withdrawal management ('detox') services. Outpatient detox is described within national Australian guidelines as a safe option for selected drinkers. However, uncertainly exists as to how suited Aboriginal and Torres Strait Islander peoples are to this approach. ⋯ There is a need to improve access to alcohol detox services for Aboriginal and Torres Strait Islander peoples. The outpatient setting seems to be a feasible and safe environment to provide this kind of service for selected drinkers.
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Good Medical Practice: A Code of Conduct for Doctors in Australia states that in caring for patients towards the end of their life, good medical practice involves facilitating advance care planning. ⋯ There has been an increased focus on advanced care planning and advance care directives in Australia, partly driven by the ageing population and technological advances, as well as the principle of patient-centred care. General practitioners have an important role in initiating and facilitating advance care planning.
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General practitioners (GPs) tend to focus most of their energies on providing primary healthcare to individuals, with less attention to the overall population health issues in their community. In contrast, public health practitioners tend to focus on the health needs of entire populations, by addressing the social determinants of health, with less attention to individual patient care. ⋯ GPs have an important role in public health both through individual patient care and by engaging with public health issues at local, community and global levels. Adopting a population perspective to healthcare is an important part of modern general practice.