Book menuYOUR FAMILY GP - Full extract 

From my point of view, being a family doctor is both a challenge and a privilege at the same time. The family GP looks after people from infancy to old age, and is often a trusted friend to several generations of the one family. He or she provides care for the whole person - physically and emotionally - in the context of the individual, the family, the workplace and the community.

Unlike the consultant specialist, the GP needs a degree of expertise in all fields of medicine. Some have special interests, such as sports medicine, counselling or undergraduate teaching, but here are some specific skills that a GP must develop and use every day:

Recognising who is sick
With a careful history and examination the GP is usually able to work out what is wrong with the patient. Investigations may be required to establish a diagnosis and help with treatment. At times the GP is able to say only that someone is seriously ill, without a precise diagnosis; this is often the case with acutely ill babies and adults unable to give a history. Sometimes it is necessary to work out over the telephone who is seriously ill.

Treating common conditions well
Illnesses such as upper respiratory infections, asthma and high blood pressure are seen every day and the GP becomes very skilled in their management. Putting in sutures, treating fractures and removing skin lesions are all part of a day's work. For many conditions all that is required is simple reassurance.

Referring appropriately
To hospitals, medical specialists and other health professionals, the GP is the central member of a health team that is focused on the needs of the patient. In medical emergencies, GPs have to be able to stabilise the patient's condition and arrange ambulance transport to hospital.

The vital role of support groups for patients, families and carers has become more evident in recent years. Whether it's diabetes, Alzheimers disease or sudden infant death syndrome, these groups provide practical information and help people cope better with illness. Various government agencies can also be of assistance.

Education, counselling and preventative medicine
These have become increasingly important roles for the GP. There are numerous opportunities for health promotion in general practice. People who smoke should be offered help to quit. Women should be asked whether their Pap smear is due and whether they know about breast self-examination and mammograms. Likewise, men should be taught how to examine their testicles for lumps, and be offered regular rectal examinations for prostate cancer. Lifestyle issues such as diet, exercise, stress and sexual health should also be discussed.

There is no doubt that general practice has changed a great deal in recent years. These days doctors do several years specialised training in the family medicine program before going into unsupervised general practice. With medical developments occurring at a startling rate, there is a much greater emphasis on continuing medical education. The structure and organisation of general practice has also undergone some major changes with the formation of local divisions of general practice. Their aim is to provide a focus for community health needs and for continuing education and research.

There are many issues confronting general practitioners: alternative practice funding, practice accreditation and the financial viability of running a quality medical practice. The present funding arrangements favor a high-volume prescription-book approach to medicine with many of the more difficult and time-consuming areas remaining poorly remunerated. Although not so cost-effective from a business point of view, services such as home visits are fundamental to proper medical care and must be retained for those who need them.

So, what is the best way to choose a GP for your family? You may already have an ideal family doctor. If you don't, ask neighbors and friends or ask at places like the local kindergarten or infant welfare centre. Aside from the clinical expertise of the doctor, the following checklist might help in making a choice:

Many of the changes in general practice indicate that it has progressively developed into a medical specialty of its own, and more changes are likely in the future.

However, some things are constant: people are interested in health and they continue to look to their GP for advice.


 Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: December 11, 2004