Aust Fam Physician
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This review takes a narrative synthesis approach - a systematic approach to interpreting complex evidence - to a broad literature review of the complex issue of medical career decision making. Addressing the Australian general practice workforce crisis requires an understanding of career choice motivators.
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General practitioners' concerns about medicolegal issues have been shown to influence the practice of medicine. This research looks at GPs' beliefs about medicolegal issues and how medicolegal concerns affect their practice. ⋯ This study found that GPs' concerns about medicolegal matters impact on their practise of medicine. While greater awareness of medicolegal issues may lead to positive impacts, the negative impact of their concerns is that some changes arise from anxiety about medicolegal matters rather than from the exercise of good clinical judgment.
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Interest by prescribers and pharmacists in the provision of individualised pharmaceutical therapy in the form of compounded medicines has grown in recent times. However, there have also been a number of case reports of patient harm associated with these medicines. ⋯ Regulators of pharmaceutical products have expressed concerns with the production, marketing and use of compounded medicines dispensed by pharmacists. This has prompted debate over the need for more regulation of these products. We propose an expansion of off label prescribing guidelines to include a risk based assessment of pharmaceutical quality, a consumer information/education strategy and the development of a code of practice for pharmacists engaging in compounding. These strategies recognise a shared responsibility among prescribers, dispensers and regulators to achieve contemporary quality, safety, and efficacy standards and support the quality use of compounded medicines.
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Review Case Reports
Overcoming communication barriers - working with patients with intellectual disabilities.
Communication styles and communication difficulties may impact on the ability of general practitioners to provide best possible health care, particularly for patients with intellectual and other developmental disabilities. ⋯ People with intellectual disabilities have different communication abilities, using a range of different styles as a group, as well as on an individual basis. They may use speech, augmentative and alternative communication strategies, or visual or behavioural cues to indicate their wants, needs or feelings. Improved collaboration between GPs, patients, and patients' support people, is encouraged to develop an individualised approach to communication with each patient and to promote best possible health outcomes and patient satisfaction.
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This study investigated the reasons for low uptake of Medicare Benefits Schedule rebated health assessments for Aboriginal people and Torres Strait Islanders in mainstream general practice in the Australian Capital Territory region. ⋯ Barriers to the uptake of health assessments include low levels of routine identification of Aboriginal and Torres Strait Islander patients, little awareness of Aboriginal and Torres Strait Islander specific GP mediated health interventions, and lack of support for preventive health interventions targeted on the basis of Aboriginal and or Torres Strait Islander status. Poor uptake is likely to persist without a more strategic approach to overcoming these barriers.