Aust Fam Physician
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Thea, aged 63 years, presents for review after a small inferior myocardial infarction (MI) 3 months previously.
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A male university student, 24 years of age, presented to his general practitioner because of a facial rash. He had a past history of eczema but no other significant past medical history and no allergies. He was not taking any regular medications.
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I recently participated in a registrar education discussion about 'heartsink' patients. What is a heartsink patient? O'Dowd appears to have coined the phrase and refers to patients who 'exasperate, defeat and overwhelm their doctors by their behaviour'. He implemented a plan to identify, discuss and actively manage the heartsink patients at his practice and his definition has led to a classification of typical trigger patients and guidelines on how to best manage these patients
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Triage involves matching resources to the patient - based on limited information - as quickly as possible. Principles from triage can be applied to the assessment and management of patients with psychological distress. ⋯ When the presenting symptoms are nonspecific, or the nature of the distress remains unclear, an approach to gathering more information over three visits is described. After this further assessment is completed, options to tailor treatment to the patient are suggested.
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The Closing the Gap Initiative - successes and ongoing challenges for divisions of general practice.
This article presents an evaluation of the activities undertaken by divisions of general practice to improve Indigenous Australians' access to mainstream primary care. ⋯ While most divisions were satisfied with their progress, ongoing challenges were identified with regard to effective identification of Indigenous patients and lack of interest among some practice staff. These need to be addressed though ongoing cultural awareness training.