Determinants of mood in general practitioners.

A pilot study was conducted in which 44 general practitioners completed cognitive behavioural self monitoring diaries. Hourly changes in emotional state were recorded together with associated circumstances. Lowering of mood was associated mainly with "hassle" at work, pressure of time, and domestic dissatisfaction. Improvement in mood was associated with domestic happiness and satisfaction at working efficiently and to time. Mood was significantly lower when the doctor was on call. Women doctors were more prone to mood changes associated with domestic matters. Responses to a questionnaire suggested that the doctors preferred traditional clinical medicine to problems of a social or psychological origin. Managerial skills would help alleviate several of the problems identified in this study and should be more prominent in the training that all doctors receive.

An analysis of lay medicine: fifteen years later.

Five hundred patients were asked what advice they had received before attending the doctor's surgery. The results were analysed and compared with an identical survey carried out in 1970. There have been few changes in the frequency and nature of lay advice over the last 15 years, with women still being the chief source of informal advice; the advice from men was generally to go to the doctor. Pharmacists play an increasing role and television is mentioned three times more often as a source of information in 1985 than 1970. Home doctor books are more up to date and are used more frequently. Self-care and lay advice remain important sources of medical care, suggesting that health education is a matter of priority.

Disability as identified from general practice records.

Thirty eight doctors who attended a postgraduate educational course provided information about disabled patients identified in a search of 7000 records. Disablement was defined as a major disruption to the normal lifestyle of patients in appropriate age and sex groups. Altogether 242 people were identified as disabled, equivalent to 32 per 1000 population, which is closely similar to that published by Harris, who identified patients by postal questionnaire. Among adults aged 15 to 64 more men were identified than women, and we suggest that a higher rate of disablement might be expected in men. Disablement among women may be underestimated because of underrecognition by doctors of disability in housewives. Fifty two per cent of all disabled people were able to attend the doctor's surgery, and 72% were receiving regular medication; 79% were dependent on relatives, but only 30% were dependent on statutory services. In the opinion of the recording doctors medical and nursing needs were well met, though not the social needs, where the importance of living alone is noteworthy.

Seeing two doctors at once in general practice.

We report the reactions of 250 patients who saw two doctors together, a general-practitioner trainer and a vocational trainee, when they came to a general practice for consultation.Over 80 per cent were neutral and the remainder were almost equally divided between those who preferred to see two doctors and those who preferred to see their own doctor alone.Selected favourable statements outnumbered adverse comments by about ten to one, although allowance must be made for the desire of patients to please their doctor.

Continuing education for general practice--analysis of a programme.

General practitioners in the Northampton area were asked to assess the various meetings of a programme of continuing education they had attended between May 1969 and May 1970. Analysis of their replies suggests that meetings which depend on previous study and encourage participation are most likely to be successful.