ABSTRACT
The visiting habits of general practitioners in the north of England in 1969 and in 1980 have been compared. During this period overall visiting was reduced by 41%. The reduction was most pronounced in repeat visits, particularly to children. There was a greater reduction in visits to patients with respiratory disease than to those with other illness. The reduction was least in visits to patients over the age of 65. New visits requested by patients were reduced by 31%, but the general practitioner still considered that about the same percentage of patients could have attended the surgery as in 1969. The reasons for these differences include flexible appointment systems, improved efficiency, better organisation of the surgery, and more flexible arrangements for certification of absence from work. Though total workload (as measured by the number of consultations with patients) has diminished, general practice has changed, being more concerned with prevention, chronic disease, and vocational training.
Subject(s)
Family Practice/trends , House Calls/trends , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , England , Humans , Infant , Infant, Newborn , Middle AgedABSTRACT
A method of collecting physician-patient encounter data is described and applied to the comparison of the clinical content of residents' experiences in the family practice office. Comparisons were made of over 1,000 consecutive unselected encounters in each of the three family practice residency programs. Considerable differences between the patients encountered by the three programs were observed and between program patients and patients attending family physicians in Iowa. It is important to monitor the demography and diagnostic status of patients attending family practice residency programs to ensure the authenticity of the residents' experience.
Subject(s)
Family Practice/education , Internship and Residency , Arizona , Iowa , MethodsABSTRACT
A total of 190 general practitioners in North-east England recorded the details of each home visit they made during a two-week period towards the end of 1969. Altogether 17,200 visits were made and these have been analysed. Two major points emerge: firstly, the extreme variation in visiting habits by general practitioners; and, secondly, the feeling that many home visits were unnecessary.
Subject(s)
Family Practice , House Calls , Adolescent , Adult , Age Factors , Aged , Appointments and Schedules , Attitude of Health Personnel , Child , Child, Preschool , Chronic Disease , England , Hospitalization , Humans , Infant , Middle Aged , Physicians/statistics & numerical data , Public Health Nursing , Respiratory Tract Infections/therapy , Social Class , Statistics as Topic , WorkABSTRACT
A survey of recurrent indigestion in four general practices (19,619 patients) showed a wide range of dyspeptic complaints. Of these 82 (4.2 per 1,000) already had a proved ulcer and 144 (7.3 per 1,000) had symptoms suggesting a duodenal ulcer and had either not been investigated or had previously had a normal barium meal. A duodenal ulcer was found radiologically in half the men (46 out of 95) but in only 16% of the women (8 out of 49). In 11 (25%) of the 46 men shown to have an ulcer a barium meal had been previously reported as normal. Evidence is put forward that ulcer symptoms in the large residue of patients with a normal barium meal (38 men, 29 women) were produced by a primary duodenal condition (duodenitis) of which ulcer was one complication.
