Aust Fam Physician
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Patients with dental infections frequently present to primary care practitioners such as emergency physicians or general practitioners. It is important for these healthcare professionals to understand how to assess and treat such conditions, including when to refer and to whom. ⋯ Maxillofacial surgeons frequently see serious cases of facial and neck infections that can easily be prevented if appropriately managed early.
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Pathology, imaging and other tests have an essential role in the diagnosis and screening for disease in medical practice. However, over-testing has recently emerged as a significant issue and has implications for the patient, doctor and health system. Vocational training is arguably the most critical period in the development of future patterns of clinical practice for the GP. This includes the development of test ordering behaviour. The general practitioner (GP) supervisor, therefore, has a key role to play in educating registrars to avoid over-testing. ⋯ Teaching should take a patient-centred focus and an emphasis on fostering a greater tolerance of uncertainty. Role modelling and demonstrated use of relevant clinical guidelines is a strong influence on registrar behaviour. Specific strategies for teaching rational test ordering include random case analysis, investigation audit, topic tutorials and use of targeted resources.
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Flashes and floaters are common ophthalmic issues for which patients may initially present to their general practitioner. It may be a sign of benign, age-related changes of the vitreous or more serious retinal detachment. ⋯ Although most patients presenting with flashes and floaters have benign age-related changes, they must be referred to an ophthalmologist to rule out sight-threatening conditions. Key examination features include the nature of the flashes and floaters, whether one or both eyes are affected and changes in visual acuity or visual field.
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There are over 332 000 Australians living with dementia. On average, families notice symptoms 3 years before a firm diagnosis is made. These symptoms are chronic and typically progressive and terminal. ⋯ GPs play a crucial part in managing the needs of people with dementia and caregivers by providing ongoing support and by facilitating access to evidence-based care. Scheduled, regular reviews of people with dementia and their caregivers should become standard practice, and psychosocial interventions that can assist both parties should be offered.