[Medical practice within the primary health care context. characteristics and new trends]

The request for a high quality clinical practice is a permanent challenge. Many conclusions have been drawn concerning the medical care and the results variability and the drifts cost. Within this context the General Practitioner has to maintain and improve his performance. Aim: To asse the agreement of primary care physicians with new trends in the specialized literature: A survey via an auto-questionnaire comprising 20 items was addressed to 50 General Practitioners of the Public Health Sector, draw chosen, in order to provide their opinion, knowledge and know-how relative to certain aspects of their daily activity. The General Practitioners' estimation of the average time for a consultation is 10 minutes; the reasons of its prolongation are the poly-pathologies, the unexplained medical symptoms and the extreme aged patients. The preferred anamnesis strategy is followed by the global method; in the relationship General Practitioner - Patient the medical aspect is prevailing on the centred patient approach [psycho - socio-medical]. The majority of General Practitioners are behaving more as teachers and advisors than as technicians and tutors. The non - explained medical symptoms are merely corresponding to psychosomatic pathologies and hidden complaints. The sanitary information promotion consists, in priority, in the use of a standard classification and then in the electronic activity registration. Our study allowed us to confirm a certain clash between our General Practitioners' practice and the new trends in the specialized literature. The validity of these results remains though dependant of a survey to be done with the Patients

[Management of female dyschesia in primary care consultation: non instrumental bio feedback]

Dyschesia, a frequent pathology, is often self diagnosed and self managed by patients and treated indiscriminately by physicians. Within the framework of therapeutic care of Dyschesia during primary care consultation could the non-instrumental Bio-feedback applied in urology stand for an alternative? prospective study on 17 dyschesic women aged between 20 and 50 who have been treated by non-instrumental Bio feedback during primary care consultations. They have been subject to a detailed anamnesa, a physical test and targeted complementary check-ups. A therapeutic protocol [non-instrumental Bio feedback] has also been applied to them. 24%of the studied cases have been recovered and an improvement has been observed at 35%of them. Positive results have been achieved when the disorder was neither ancient [>3 years] nor severe [Score<4]. The non-instrumental Bio feedback for Dyschesia cases should stand for a prior phase to instrumental Bio feedback more invasive and by far more expensive