[Primary care] Introduction

In the United Kingdom, most primary care occurs in General Practice.
Most General Practitioners (GPs) work in private businesses known as 'GP surgeries', 'group practices' or 'medical centers'.
GPs who hold stakes in the business are known as 'GP partners'.

GPs are specialised in primary care. This involves running daily clinics in the community and seeing large numbers of patients in each session.
GPs are the first point of contact for most patients, so almost any disease can present to them. For this reason, they must be competent in all fields of medicine.

General practice is known in several countries as 'practice medicine', 'house doctor medicine' or 'family medicine'.

 

Responsibilities

• Promoting a healthy lifestyle (primary prevention of disease)
• Detecting early disease processes and preventing progression to symptomatic disease (secondary prevention) 
• Preventing progression of symptomatic disease (tertiary prevention)
• Initiating any urgent therapy before tests
• Organising preliminary tests 
• Interpreting test results 
• Making referrals to the appropriate specialties 
• Interpreting discharge letters from specialists  
• Managing medications in the long-term   
• Managing medical emergencies which occur in the community 

There is significant overlap with dermatology. Dermatology complaints are common, and they usually present to primary care first because they are relatively benign or slow progressing. Many chronic dermatological conditions are suitable for community management.

Some patients, who present to general practice, require immediate hospital-based care. They may be directly referred to an appropriate ward or to an emergency department. An ambulance service may be contacted to bring them to hospital as fast as possible.

 

Etymology

Latin generālis, generālis, generāle = general
Ancient Greek πρᾱκτικός (prāktikós) = practical
Ancient Greek πρᾱκτική (prāktikḗ) = practice

 

Common presenting complaints:

• Low mood
• Tired all the time (TATT)
• Anxiety
• Stress
• Concerned about pigmented skin lesion
• Urinary frequency
• Urinary incontinence  
• Faecal incontinence 
• Frequency of bowel movements 
• Unexplained weight loss
• Chronic, painful or productive cough 
• Coughing up blood (haemoptysis) 
• Fever 
• Diarrhoea
• Constipation
• Blood on the toilet paper 
• Fresh blood in stools
• Abdominal pain
• Back pain
• Joint pain
• Chest pain 
• Rash 
• Infected skin lesion
• Itchiness
• Needing contraception  
• Erectile dysfunction 
• Failed conception  
• Pain periods (dysmenorrhoea) 
• Heavy periods (menorrhagia)

 

Common problems:

• Major depression 
• Generalised anxiety disorder 
• Social problems
• Acne vulgaris
• Essential hypertension
• Diabetes mellitus
• Dyslipidaemia 
• Atrial fibrillation 
• Hypothyroidism  
• Anaemia
• Acute infections 
• Minor trauma 
• Folliculitis 
• Emotionally unstable personality disorder

 

See also:  

• List of the most common diagnoses in 2016