Comparison of the medical counseling by PC communication between family medicine and internal medicine according to ICPC

BACKGROUND: The purpose of this survey was to assess knowledge of the public on family medicine through the analysis of medical counseling by PC communication and to compare them with that of internal medicine. METHODS: This survey analyzed the contents of medical counseling by PC communication according to ICPC from Oct. 1996 to Jun. 1998. The survey was done by means of E-mail in Nownuri eyes and the selected medical departments were those of those of family medicine and internal medicine in Pusan National University Hospital. RESULTS: The total number of questions was 342, including 181 in the department of family medicine and 161 in internal medicine. In the analysis of medical counseling according to ICPC, there was a significant difference between family medicine and internal medicine in the reasons for questions by components(P<0.001). In family medicine, the reasons were symptoms, complaints(66.9%), diagnoses, diseases(18.8%), treatment, procedure, medication(17.2%), and diagnostic, screening, prevention(5.5%). In internal medicine, the reasons for questions were symptoms, complaints(64.6%), diagnoses, diseases(21.1%), treatment, procedure, medication(9.3%), and test results(4.3%). There was a significant difference between family medicine and internal medicine in the questions by chapters(P<0.05). In family medicine, the questions about digestive system were 28 cases(15.5%), neurological system were 26 cases(14.4%), skin were 26 cases(14.4%), musculoskeletal system were 25 cases(13.8%), and unspecified were 25 cases(13.8%). In internal medicine, the questions about digestive system were 76 cases(47.2%), circulatory system were 21 cases(13.0%), and respiratory system were 15 cases(9.3%). The most common symptom was headache in family medicine and generalized abdominal pain in internal medicine. CONCLUSIONS: There were significant differences in the age distribution, the reasons for questions, and the contents of questions between family medicine and internal medicine.

Comparison of family medicine and internal medicine residents: fine needle aspiration cytology of thyroid nodul

BACKGROUND: Fine needle aspiration cytology is an effective and important diagnostic procedure to distinguish benign from malignant thyroid nodule. The purpose of this study is to compare the results of thyroid fine needle aspiration cytology performed by the residents of family medicine and internal medicine. METHODS: Among patients who underwent fine needle aspiration cytology for differential diagnosis of thyroid nodule at the department of family medicine, Pusan National University Hospital from July 1996 to June 1998, we randomly selected 96 patients. We also selected 96 control patients at the department of internal medicine. We assessed the patients age, sex, accompanying symptoms, diagnostic procedures, pathologic results of fine needle aspiration cytology from the medical records and biopsy records. For statistical analysis, we used t-test and Chi-square test. RESULTS: Mean age of 96 patients of family medicine was 44.4 years. Females were 89(92.7%) and males 7(7.3%). Age and sex distributions were not significantly different from that of internal medicine patients(p>0.05). Patients with thyroid nodule had underwent fine needle aspiration cytology(100.0%), thyroid function test(76.0%), thyroid scan(49.0%), and thyroid ultrasond(35.4%). There were more thyroid scans performed in the intemal medicine department, as there were more ultrasonograms done in the family medicine department(p0.05). Complications of aspiration were rare and not significantly different between the two departments(p>0.05). CONCLUSIONS: Pathology results and complications of fine needle aspiration cytology performed by residents of family medicine and internal medicine were not significantly different.

What do residents of family medicine discuss after outpatient care?

BACKGROUND: Physicians who provide primary care should be trained specifically to manage the problems encountered in a primary care practice. This study was carried out to know the resident's concerns and problems during outpstient care by analysing case discussions as an outpatient teaching. METHODS: We used 533 records discussed by 3 resident's teams for 1 year. Of discussion contents, symptoms or diseases were classified into codes and chapters using the ICPC(lnternational Classification of Primary Care) coding system and the main topics of discussion into 12 types. We compared data among 3 resident's teams and also between the discussed contents and the diseases of patients who visited a family practice for 1 year. We used relative discussion ratio to compare data. RESULTS: Of 533 discussed records, 106 kinds of symptoms or diseases were used and the 20 most common kinds accounted for 61.7%. Contents about menopausal sympto/complaint were 47 records(8.8%) and was the most frequent. Digestive part was the most frequent chapter(22.0%). Distribution of discussed main topics were diagnosis(35.5%), medication(26.8%), other treatment(11.6 %), follow-up(5.8%), etc. There was some difference among 3 resident's teams by chapters and topics. Visiting patients were 3,436 persons with 79 kinds of symptoms and diseases and prior 20 kinds accounted for 86.6%. Visited patients were some what different with the discussed contents by chapters. CONCLUSIONS: Contents of case discussion in ambulatory setting were some what different among each teams and more diverse than the visiting patients The residents could exchange many informations and find problems during ambulatory care. We think case discussion can be a good method for outpatient teaching.

Factors related to awareness of hypertension

BACKGROUND: Hypertension is a common disease and one of the most important risk of cardiovascular disease. Majority of patients with hypertension are unaware of their conditions until complications develop. Awareness of hypertension is important in treating and controlling of hypertension. Therefore, we conducted a study on the factors related to awareness of hypertension. METHODS: Awareness of hypertension was evaluated by measuring blood pressure(BP) in 3,344 subjects visiting a health promotion center in Pusan National University Hospital from June 1996 to May 1997. All subjects completed a questionnaire including socio-demographjc factors and family history. Hypertension was defined as systolic BP above 140mmHg and/or diastolic BP above 90mmHg. 135 subjects were diagnosed as hypertension. RESULTS: Among 315hypertensives, only 135 subjects(42.9%) were aware of their conditions. With respect to sex, women had a better awareness of hypertension than men(51.6% vs 36.9%, P<0.05). The awareness was greater for the subjects aged over 60years than for the subjects aged 30-49 years(53.3% vs36.5%), and it was statistically significant(P<0.05). The subjects with stage III hypertension had a better awareness of hypertension than the subjects with stage I(65.5% vs 32.6%, P<0.05) In the occupation-types, the awareness was highest in the group without occupations. But except the group without occupations(56.2%), the awareness was highest in the group of domestic affairs(housewives, 53.2%). Education level and monthly mean income were not related to awareness of hypertension. With respect to marital state, the rate of awareness is highest in the group of widows or widowers(55.8%, P<0.05). The subjects with family history of hypertension had a better awareness of hypertension than the subjects without(59.6% vs 35.7%, P<0.05). The rate of alcohol drinking(47.4% vs 66.7%), smoking(21.5% vs 31.6%) and high salt intake(17.0% vs 25.0%) were lower and the performance rate of regular exercise(24.4% vs 13.3%) was higher in those who were aware of their hypertensions than those who were not. CONCLUSIONS: The awareness of hypertension was also associated with sex, age, marital sate, occupation, stage of hypertension, family history of hypertension, and was related to performance of lifestyle modification (alcohol drinking, smoking, salt intake, exercise).