entire issue. - The Royal New Zealand College of General ...

More documents

Recommendations

Info

EDITORIALs FROM THE EDiTOR editor. The electronic version of JPHC is available free; we aim to publish ‘in press’ papers online prior to release of the hard copy, and electronic discussion will come as soon as the IT capacity is available. The mission for JPHC reflects that of NZFP—publish original relevant research, provide educational updates, stimulate critical thinking and debate and reflect on changes in modern general practice. 21 The mission for JPhc reflects that of NZFP—publish original relevant research, provide educational updates, stimulate critical thinking and debate and reflect on changes in modern general practice To follow through on Ian St George’s culinary metaphor, 4 JPHC offers a smörgåsbord of wholesome dishes. Continuing professional education is served as simple, fresh and local morsels. Essays and editorials offer more meaty fare—tasty but easily digestible. Original scientific papers have pride of place at every table, presented in a palatable fashion. Readers either may merely pick at the abstract and summary box, or devour the studies in their entirety. You may choose to graze from time to time or to sit down for the full meal. Either way, I wish you bon appétit. References 1. Murdoch C. What’s in a name? nZ Fam Physician 2008;35(6):12–15. 2. Ministry of Health. The Primary Health Care strategy. Wellington; 2001 Feb. 3. West R. Regarding my editorship. nZ Fam Physician 2008;35(6):7–8. 4. st George i. A bright future for the journal. nZ Fam Physician 2008;35(6):5–6. 5. Arroll B, Kerse n. Back to Back: GPs should prescribe more benzodiazepines for the elderly. J Primary Health Care 2009;1(1):57–60. 6. Wallis K. Uncertainty, fear and whistling happy tunes. J Primary Health Care 2009;1(1):71–73. 7. Moir F, van den Brink R, Fox R, Hawken s. Effective communication strategies to enhance patient self-care. J Primary Health Care 2009;1(1):67–70. 8. Corin A. Mind over matter—implications for general practice. J Primary Health Care 2009;1(1):77–79. 9. Bennett P. Bridging two worlds in the interview process—the psychiatric assessment and Maori in primary care. J Primary Health Care 2009;1(1):63–65. 10. Crampton P. A primary care-led medical education system? J Primary Health Care 2009;1(1):5–6. 11. Parsonson B. Using psychoactive medication to intervene in children’s behaviour: An evidence-based practice? J Primary Health Care 2009;1(1):6–10. 12. Mathieson F, Collings s, Dowell A. sub-threshold mental health syndromes: Finding an alternative to the medication of unhappiness. J Primary Health Care 2009;1(1):74–77. 13. Dovey s. Transitions. nZ Fam Physician 2008;35(6). 14. Arroll B, Goodyear-smith F, Kerse n, Hwang M, Crengle s, Gunn J, et al. The prevalence of depression among Maori patients in Auckland general practice. J Primary Health Care 2009;1(1):26–29. 15. Calveley J, Verhoeven A, Hopcroft D. A patient-centred referral pathway for mild to moderate lifestyle and mental health problems: does this model work in practice? J Primary Health Care 2009;1(1):50–56. 16. Wheeler A, Harrison J, Homes Z. Cardiovascular risk assessment and management in mental health clients: perceptions of mental health and general practitioners in new Zealand. J Primary Health Care 2009;1(1):11–19. 17. Hanisah A, Khairani Os, A. Prevalence of acne and its impact on the quality of life in school-aged adolescents in Malaysia. J Primary Health Care 2009;1(1):20–25. 18. norris P, Churchward M, Fa’alau F, Va’ai C. Understanding and use of antibiotics amongst samoan people in new Zealand J Primary Health Care 2009;1(1):30–35. 19. Robb G, Arroll B, Reid D, Goodyear-smith F. summary of an evidence-based guideline on soft tissue shoulder injuries and related disorders—Part 1: Assessment. J Primary Health Care. 2009;1(1):36–41. 20. Robb G, Arroll B, Reid D, Goodyear-smith F. summary of an evidence-based guideline on soft tissue shoulder injuries and related disorders—Part 2: Management. J Primary Health Care 2009;1(1):42–49. 21. Townsend T. Editing the nZFP. nZ Fam Physician. 2008;35(6):16–18. 4 VOLUME 1 • nUMBER 1 • MARCH 2009 J OURnAL OF PRiMARY HEALTH CARE
A primary care–led medical education system? The primary health care sector is an underutilised resource for medical education. The combined forces of ageing demographics, advances in community-based medical treatments for chronic diseases, a commitment to reducing health inequalities, and cost pressures increasingly conspire to push health care into primary care settings. Medical education must mirror this trend—if for no other reason than the practical imperative that medical education needs to occur where the bulk of treatment occurs. The numbers are compelling: four out of five children and adults visit their GP at least once in a 12-month period, and with a mean number of visits being 3.2 this accounts for millions of individual contacts. 1 About one quarter of children and adults use a public hospital service in a 12-month period (counting emergency department use, outpatient, day case and inpatient episodes). 1 Our medical graduates must be prepared to meet the treatment patterns reflected in these numbers. The shift of medical education into community settings is happening in many countries, and is readily evident in New Zealand with the setting up of rural programmes at both our medical schools, the increasing use of general practice in undergraduate medical education, and government funding support for increased numbers of vocational training places for general practice. But the barriers to increasing primary care–based medical education are numerous. Not least is the lack of a long-established tradition of widespread, routine, undergraduate medical education in primary care, resulting in weak or absent basic physical infrastructure for teaching, the absence of a well-established pattern of GP registrars teaching undergraduate medical students as occurs in hospitals, and poor career structure for primary care–based teachers. Added to this is the relatively low level of government support for specialist GP vocational training compared with other specialist training programmes, notwithstanding the strong policy emphasis this decade on New Zealand’s ‘primary care–led health system’. Then there is the sticky problem of ownership; we need to find mechanisms for government to invest in basic infrastructure for primary care–based education in a way that secures and protects public investment and simultaneously meets the needs of trainers. A head of steam is rapidly building to see these problems addressed, fuelled by recognition not only of the above issues, but also that the current training system is not especially orientated towards equipping graduates for a career in primary care. This point is well made in a recent report of the Workforce Taskforce: 2 The traditional model of training doctors and nurses focuses on preparing them to work in hospital environments. This model does not meet the demands of an aging population, the rise in chronic disease and co-morbidities, and the emphasis on treatment in the community. Primary health care requires a workforce with skills and competencies to implement primary and population health services in the community. Practitioners need to be flexible, contextually responsive, innovative and engaged in a process of life-long learning. A new and exciting development is the recent establishment of a project by the Universities of Auckland and Otago and the RNZCGP. They have jointly funded the establishment of a National General Practice Clinical Placement Coordination position. The first-year objectives of this project are to: • coordinate student and registrar placements in general practice settings; EDITORIALs GUEsT EDiTORiAL Peter Crampton MBChB, PhD, FAFPHM, MRnZCGP, Dean and Head of Campus, University of Otago Wellington CORREsPOnDEnCE TO: Peter Crampton school of Medicine and Health science, University of Otago, Wellington, PO Box 7343, Wellington, new Zealand peter.crampton@ otago.ac.nz VOLUME 1 • nUMBER 1 • MARCH 2009 J OURnAL OF PRiMARY HEALTH CARE 5
Page 1: OF PRIMARY HEALTH CARE ‘It is pos
Page 4 and 5: EDITORIALs FROM THE EDiTOR Felicity
Page 8 and 9: EDITORIALs GUEsT EDiTORiAL Barry S
Page 10 and 11: EDITORIALs GUEsT EDiTORiAL cial int
Page 12 and 13: EDITORIALs GUEsT EDiTORiAL depressi
Page 14 and 15: ORIGINAL SCIENTIFIC PAPERS qUANTITA
Page 32 and 33: ORIGINAL SCIENTIFIC PAPERS MIXED ME
Page 38 and 39: ORIGINAL SCIENTIFIC PAPERS SYSTEMAT
Page 52 and 53: iMPROViNg PERfORMANCE 1 Harbour Hea
Page 54 and 55: iMPROViNg PERfORMANCE Figure 1. Pri
Page 56 and 57:
iMPROViNg PERfORMANCE Patient comme
Page 58 and 59:
iMPROViNg PERfORMANCE ACkNOwLEDgEME
Page 60 and 61:
BACk TO BACk fewer/no falls? He cho
Page 62 and 63:
BACk TO BACk are not safer than lon
Page 64 and 65:
CONTiNUiNg PROfEssiONAL dEVELOPMENT
Page 66 and 67:
Page 68 and 69:
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
EtHiCs unknown, and to manage the p
Page 76 and 77:
EssAYs sub-threshold mental health
Page 78 and 79:
EssAYs training for psychological t
Page 80 and 81:
EssAYs Resonance Imaging (MRI) anal
Page 82 and 83:
LETTERS TO THE EDITOR Vignette from
Page 84 and 85:
BOOK REVIEWS The Baby Business: Wha
Page 86 and 87:
BOOK REVIEWS Review by Ms Helen Rid
Page 88 and 89:
RESEARCH GEMS GemS Of NeW ZeAlAND p
Page 90:
JOURNAL OF pRIMARy HEALTH CARE The
show all

entire issue. - The Royal New Zealand College of General ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?