Aust Fam Physician
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Patients with multimorbidity are increasingly common in general practice. Multimorbidity is a challenge for both patients and practitioners because of the complexity of care and its impact on patients' lives. Single-disease-based guidelines are of limited use to providers managing patients with multimorbidity. ⋯ Providing effective care for multimorbidity requires shared decision-making about goals with patients and more effective communication and coordination between providers. For this group of patients, our current single-disease-based models of care need to be replaced with more integrated ones in which the impact of all the patient's conditions on their quality of life are considered.
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This study sought to gain insight into how Deaf Australians who use Auslan as their primary language perceive their English literacy and if they feel that they can sufficiently access preventative and ongoing health care information, and to explore their views in regards to accessing information in Auslan. ⋯ Many Deaf people in Australia lack consistent access to preventative and ongoing health care information. It is important to be aware of the English literacy levels of patients. More funding is needed for the provision of interpreting services in other healthcare contexts and the translation of materials into Auslan.
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The increasing use of routinely collected data in electronic health record (EHR) systems for business analytics, quality improvement and research requires an extraction process fit for purpose. Little is known about the quality of EHR data extracts. We examined the accuracy of three data extraction tools (DETs) with two EHR systems in Australia. ⋯ Current DETs are not reliable and potentially unsafe. Proprietary EHRs and DETs must support transparency and independent testing with standardised queries. Quality control within an appropriate policy and legislative environment is essential.
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The review of a doctor's fitness to practice is being increasingly discussed internationally. The Medical Board of Australia has recently announced a desire to explore this issue. The United Kingdom (UK) introduced revalidation for doctors last year. The UK revalidation system is an enhancement of the National Health Service appraisal system that requires doctors to participate in annual appraisals conducted by trained peers. The appraisal process involves four stages: submission of a range of information; a confidential appraisal discussion; a personal development plan; and a post-appraisal sign-off. The criteria that doctors are assessed against are detailed in the General Medical Council's guidelines of Good Medical Practice. Satisfactory participation in the appraisal process over a 5-year cycle is likely to result in a recommendation for successful revalidation. ⋯ The revalidation process has been beneficial from a personal perspective, but the range of consequences and subsequent support mechanisms need to be considered and addressed.
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Neck pain is a common presentation in general practice. Nevertheless, recommendations for the investigation and management of neck pain lack a strong evidence base and are predominantly extrapolated from low back pain studies. ⋯ Although sinister causes of neck pain are rare, clinicians must be mindful of red flags that may indicate serious pathology. The medical interview, rather than the physical examination, remains the most critical step in determining the likely cause of cervical spine pain, whereas biochemical tests and imaging are not part of routine assessment. The classification of neck pain into acute or chronic patterns, extrapolated from the low back pain literature, may help stratify the need for intervention and the likely prognosis of neck pain. A more concerted research effort is needed to help better understand and develop evidence-based guidelines for the management of neck pain.