Reason Articles

History of Family Medicine Specialty

Historically doctors used to be generalist practitioners. However during the past fifty years, technological and scientific advances have brought exciting prospects in medicine. The fragmentation of medicine into subspecialties has produced advances in our understanding of diseases. Generalist mode of practice languished, while spectacular advances were made by subspecialists who were concentrated in pij2hospitals, with expertise in single organs, systems or diseases, in the performance of specific procedures or in the use of expensive and advanced equipment.New investigations including blood,biochemical,  radiology and genetic created a new era to disease diagnosis and monitoring. Read more.

GPRA Video from You tube

AKT Questions

Click on the button

KFP questions

 This blended online learning program is delivered via the PIJ news with support of our general practitioners. Learning modules are planed to develop based on Sri Lankan general practice set up. All of you have free access to theses programs  Online tutorials are planned to deliver regularly by experts in the field in near future.Here you are given the patient and history. All what you need to do is manage the patient and check whether you managed him correctly

I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

  1. I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

SCENARIO : John Johnston  is a 50 year A regular patient . He have been
on Fluaxetine for his  depression for 6 months . He also referred you for psychotherapy and symptoms improved.

Allergies: Nil, Social History
Occupation: laborer
Lives alone, good friends with neighbours
Usually active and successful in local sports teams but recently pulled out due to
tiredness
Family History
Estranged from partner. Has a 10 year old son whom he loves but only sees monthly
Current Medications
Sertraline 100mg daily
Immunisations Up to date
Past Medical History
Depression
Lacerated finger
Supraspinatus tendonitis
Drug and Alcohol. Nil known, non smoker

You are a 48 year old plumber who has been seeing the doctor on and off for the last 3 months for
depression. You have mainly been feeling down, tired, don’t want to go to work, don’t enjoy sport any
more. You have been improving with medication. Yesterday you found out that your estranged partner
is moving 4 hours away and taking your son with her. You are usually able to see your son, (whom you
love a great deal) every month, now it is likely to be only yearly. You get on well with your neighbours.
Until 4 months ago you were an active and successful member of several local sporting teams
Information to be freely given:
Any of the Above.
That you want to end it all, tired of everyone being against you etc. etc.
If you can’t see you son then nothing’s worthwhile
You just wanted to stop by and say “thanks for the help, don’t think it is your fault Doctor”.
Information only to be given with appropriate enquiry from the candidate:
You have your car outside with a tube in it ready to attach to the exhaust (or whatever method you have
chosen, it’s all ready to go). All details planned. You have given away your tools of the trade to your
apprentice. You have given your treasured items to neighbours. You have left a letter and a gift for your
son in your house.
You WILL NOT go to the hospital if this is suggested.
If they threaten to call the police etc then you will try and leave.
However, you will calm down if the candidate makes you think about the consequences of your actions
on your son or other loved ones. And if they have calmed you down, then you will sit quietly and wait
for someone to pick you up to go to the hospital to get some help.
If you have not been made to think about the consequences then you will storm and rant and tell of your
plan and how the police won’t be able to catch you.
NOTES

SECTION C: This information is given to the examiner/facilitator
Listed below are the key issues to be covered in this case. (The facilitator/examiner can “tick”
these as covered during the consult)
Specific Questions Candidate should ask
Why he has got to this point
Gauge seriousness of intent
Supports
Appropriate management and explanation:
Listen empathetically
Try and make Peter think about the consequences of his actions eg. Son growing up without even phone
calls or holidays with his dad, who will find him, etc
Ensure safety, calling Crisis Assessment team/police/good friend to take him to hospital.
Main priorities – ensure safety of patient and significant others. Voluntary admission if possible. Call on resource of
Practice/CAT/Police/Other for assistance of required.

I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

2019/11/10 00:00:19