Female general practitioners in Maine-et-Loire: "1990-2000"

In 1990, there were approximately 60 female general practitioners in the Maine-et-Loire region, 58 of which participated in the survey that year. By the year 2000, the number had risen to 137. A new study was conducted involving 70 women who had opened practices over that decade. Analyses of the responses to the questionnaire and a comparison with the results of the previous survey demonstrate distinct changes and a real evolution in the working conditions of this new generation of female general practitioners and in their relationships with their colleagues and families. More involved in their work and professional lives, they are now more accepted by other physicians and enjoy real family support. They are fulfilled and appear to succeed fully in all of their roles--those of physician, mother and wife. More active participation in social and political life would enable these professionals to achieve greater self-fulfillment and satisfaction; it is perhaps still too early to comprehend the true specificity, if any, of the private general practice of medicine by women. A new survey is planned to be conducted in ten years.     

Smoking by French general practitioners: behaviour, attitudes and practice

INTRODUCTION: This paper examines smoking prevalence, sociodemographic factors and the medical practice of French general practitioners. METHOD: Data from the 1998 cross-sectional national survey of 2,073 GPs. The questionnaire was administered by telephone. A response rate of 67% was attained. Instrumentation included questions about medical practice, sociodemographic characteristics, and health behaviour. Bivariate and multiple logistic regression (MLR) analyses were conducted. RESULTS: Almost one-third (32.1%) of physicians were current smokers. A significantly higher proportion of male (33.9%) were smokers compared to women (25.4%, p<0.001) and men were more likely to be former smokers (49.1% versus 31.7%). Two-thirds of physicians reported recommending nicotine replacement therapy to their patients. MLR shown that former smokers were more likely (OR = 1.51, 95% CI, 1.24-1.83) to indicate that their help in getting patients to quit was not effective compared to smokers. Also, physicians who were 'dissatisfied' with the profession were more likely (OR = 0.75, 95% CI, 0.60-0.92) to report their help as not effective than those who were 'satisfied'. CONCLUSION: These data support the need for greater professional participation in reducing smoking among general practitioners in France and greater education concerning the vital role of physicians in promoting cessation among the general population. KEY POINTS: This study examines smoking habits among French GP's, intervention practices, and opinions about their ability to help patients quit smoking. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women.     

Drugs prescribed by general practitioners

General practitioners have a personal list of drugs which they prescribe. As new drugs become available and older drugs are outmoded, the doctor will change this personal list. The reasons for making such changes are discussed, and also the question of the perceived mechanism of action of the drug, particularly in relation to the placebo effect.     

Cancer prognosis by general practitioners

Background: General practitioners are probably asked regularly about the prognosis for patients with cancer. There is no readily available source of information on the accuracy of their estimates.

Objective: To discover studies that have reported general practitioners estimates of prognosis.

Methods: A search for studies of estimates of prognosis in terminal cancer by general practitioners.

Results: Three papers were discovered, reporting on 836 patients. In only a quarter of patients was prognosis accurately estimated by general practitioners, even within broad limits. Hospital doctors and nurses performed similarly. We suggest considerable scope for further studies in general practice, which should not require sophisticated procedures.

Conclusion: Evidence of GP's limited performance in cancer prognostication should push us to do better.     

Methadone treatment by general practitioners in Amsterdam.

In Amsterdam, a three-tiered program exists to deal with drug use and addiction. General practitioners form the backbone of the system, helping to deal with the majority of addicts, who are not criminals and many of whom desire to be free of addiction. Distinctions are made between drugs with "acceptable" and "unacceptable" risks, and between drug use and drug-related crime; patients who fall into the former categories are treated in a nonconfrontational, nonstigmatizing manner; such a system helps prevent the majority of patients from passing into unacceptable, criminalized categories. The overall program has demonstrated harm reduction both for patients and for the city of Amsterdam.     

Usage of information sources by general practitioners

Questionnaires were sent to approximately 500 general practioners in five areas of one National Health Service Region; there was a 52% response. Certain characteristics of each general practitioner, which were collected from the questionnaire and medical lists, were used to assess how information was used by different `types' of general practitioner. Generally, sources of information emanating from the pharmaceutical industry are used more to introduce the new product, while the `professional' sources such as medical journals are used more to evaluate it. Younger doctors used Drug and Therapeutics Bulletin more than did their colleagues, and single-practice doctors found the representative to be more useful than did joint-practice doctors.     

Migraine in general practitioners.

A self-administerd questionnaire was posted to 1 129 medical general practitioners in an urban and in a rural area of England. The prevalences of headache, and of the features of migraine, in the year immediately preceding the survey were similar in the two areas. After allowing for the different age and sex composition of the populations, these prevalences were also similar to those found in the general population during an early survey in Wales. About 13% of the male and 25% of the female general practitioners thought that they had had migraine in the previous year. There was little evidence that doctors with 'classic' migraine differed from those with 'common' migraine in the proportion who experienced other migrainous features (unilateral distribution of headache and accompanying nausea) or in their response to treatment with ergotamine.     

Experience in training of general practitioners

The pedagogical experiment indicated that the effective training of general practitioners could be realized through the system of intern and resident training which made it necessary to prolong the term of study up to 12 weeks for interns in the out-patient departments and up to 4 months for resident physicians. The retraining of district therapists enabling them to work as general practitioners could be successfully effected at the departments of advanced medical training in the course of 5 months.     

Men's health promotion by general practitioners in a workplace setting

ABSTRACT: A project to promote men's health through diabetes education and screening was undertaken throughout rural industries in 1999/2000 in the south-west of Western Australia. Five hundred and twenty-five men aged 40–65 years participated from 27 industries. Sixty-four per cent of these men were identified at high-risk of developing diabetes and were referred to their general practitioner (GP) for follow-up. Seventy-six per cent of those at-risk visited their GP and hence the strategy adopted has been appropriate in engaging men in the preventive concept of seeking care, that is, getting them to attend their GP when they only have the risk factors but not the disease. However, men were left short of knowing how to achieve a change in their lifestyle behaviour and take appropriate action. Given the constraints of rural practice and the need to prioritise those with disease and gaps in service provision for both health services and GPs, there are two challenges: identifying those at-risk and modifying their behaviour.