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On the question of quality context is everything

The question of quality in primary care is a vexed one. According to the King's Fund: We have suggested some ways that practices could begin to audit their own practice.... and made recommendations about how the work we have begun could be used as … [Read more]

What is the role of doctors in health promotion?

Our health is a cause for concern. Over 1 in 5 Australians aged 18+ (22%) reported having Cardiovascular disease in 2011. In 2009, the risk of being diagnosed with cancer before their 85th birthday was 1 in 2 for males and 1 in 3 for … [Read more]

Why our jobs are making us fat

We spend most of our time at work. Expressed as terms of a percentage of your life, this 39.2 hours a week spent working is equivalent to: 14% of your total times over the course of a 76 year period (based on the average projected life … [Read more]

What’s the shortest route to where you want to go?

As the conference season begins we note that response rates in the order of 10-20% are not unusual in primary care research. Hardly generalisable. And yet we need sustainable and workable solutions that will promote health and well being in an ageing … [Read more]

You are one of us doctor you’ll understand

The door opened a crack and I could just make out a face in the half light. The doctor I spoke to was Irish, who are you? I assured the patient that I was indeed the person they spoke with when they requested a home visit. Reluctantly, they let me … [Read more]

If your fix only works if people choose option A abandon it

There is an obsession with getting clinicians to 'follow guidelines'. There are those in the world who appear to believe with an evangelical zeal that 'if only' people over there would do as we tell them everything would be fine. They rely on the … [Read more]

A cough is not minor in any sense

   Acute cough, which often follows an upper respiratory tract infection, may be initially disruptive but is usually self‐limiting and rarely needs significant medical intervention. Thorax In adults or children with acute cough, the evidence … [Read more]

It is time for primary care to enter the triggering business

It has been suggested, some would say demonstrated that doctors know very little about their patients. If you are a doctor could you identify your patient's partner from a line-up of strangers (other than people you see as a couple)?  Or could you … [Read more]

Why when you are sick don’t you do what you can to help yourself?

At 68 Frank has been prescribed the usual mix of medications: three different drugs for blood pressure, a statin and two different pain killers. His problems, as he lists them are fatigue, snoring and back pain. From his doctor's perspective, the … [Read more]

Does encyclopaedic technical knowledge make a doctor?

Life as a clinician is challenging.  Hours are long and resources limited. People may not be helpful, not even the ones who are supposed to be working with you or even for you. There maybe joy but there will also be sadness and even anger. You can … [Read more]