The British journal of general practice : the journal of the Royal College of General Practitioners
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Despite the growing literature on frequent attendance, little is known about the consulting patterns of frequent attenders with different doctors. To develop appropriate intervention strategies and to improve the clinical care of frequent attenders, a full understanding of these consulting patterns is essential. ⋯ The reasons why some doctors have more consultations with frequent attenders is unclear. Some doctors may actively encourage frequent attendance. While many frequent attenders have clear allegiances to one doctor, many also consult widely with a large number of doctors. The consequences of such behaviour are unknown. These findings have important implications in the development of appropriate interventions for reducing problematic frequent attendance.
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Eighty practice managers identified 55 colleagues with disabilities in a postal survey. Most of the 15 people with disabilities who were subsequently interviewed described colleagues having helpful attitudes but changes had not been made to practice workplaces or systems to retain them at work. Proactive support for disabled workers might improve retention in the National Health Service workforce.
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General practitioners' (GPs') advice against smoking has a small, beneficial effect on patients' smoking. Consequently, GPs have been urged to adopt a population-based approach to advice-giving that involves discussing smoking repeatedly with the maximum possible number of smokers. This discussion paper assesses how far GPs' current clinical practice is from a population-based approach to advice-giving and finds that GPs prefer a problem-orientated approach to advising those who present with smoking-related problems. Discussion focuses on the feasibility of suggesting that GPs adopt a population-based approach instead.
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In the light of sub-optimal uptake of the measles, mumps, and rubella (MMR) vaccination, we investigated the factors that influence the intentions of mothers to vaccinate. ⋯ A major reason for the low uptake of the MMR vaccination is that it is not perceived to be important for children's health, particularly the second dose. Health education from GPs is likely to have a considerable impact.
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Previous research identifying the long-term mentally ill in primary care has been outside areas of deprivation. We used a case finding approach by a primary care group to identify the prevalence and characteristics of people with enduring and disabling mental ill health in a disadvantaged inner-city community. ⋯ The approach may be useful for local needs assessment. It highlights a need to consider disability as well as diagnosis for service development.