Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： General practitioners with sub-specialties can not only provide high-quality general medical services， but also provide a certain depth of specialized medical services. The combination of general practitioners with sub-specialties of different specialties can provide relatively comprehensive and certain depth of basic medical services for residents in their jurisdictions. Under the situation that the professional service capacity of mental health cannot meet the needs of residents，the necessity of encouraging some general practitioners to develop mental health subspecialties has become increasingly prominent. This article analyzes the necessity of training general practitioners with psychosis subspecialty; The advantages of developing psychosis subspecialty among general practitioners; The obstacles to promoting the development of psychosis sub-expertise of general practitioners in primary care are proposed：the construction of general practitioners training bases for psychosis sub#2;expertise; The learning platform for general practitioners with psychosis sub-expertise was expanded; Construction of sub-specialty teachers of psychosis; Policy and financial support，salary and promotion incentive policies，etc.，are expected to help general practitioners develop psychosis sub-expertise.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-29 Cooperative journals: 《中国全科医学》
Abstract： General practice in China has developed rapidly in recent years with remarkable progress， but the gap with developed countries in Europe and the United States is still large，and the training system of general practitioners still remains impefect. In Germany，the construction of the primary health care system and the training system of general practitioners have been well developed. Under the system of universal health insurance coverage and hierarchical diagnosis and treatment，a high level of health and patient satisfaction with primary healthcare services among residents have been achieved in Germany. Therefore，this study compares post-graduate education and continuing education of general practice in China and Germany， analyzes the challenges of general practice education reform in China，drawing on the conceptual framework of general practice education in Germany，and proposes targeted ideas and recommendations for solutions as follows：for the standardized residency training of general practice， increase the rotation flexibility as appropriate to facilitate the optimization of trainees' individualized competencies，incorporate the standardized curriculum of psychosomatic medicine and Balint group training to improve trainees' competence in psychosomatic medicine，establish standardized selection criteria and promote standardized training program for faculty of community hospital，and revisit the duration of general practice （including community） rotation after improving the qualifications of general practice faculty of community hospital ; for the continuing education，incorporate the special interest and small specialties into the general practice continuing education system to strengthen the functional medical characteristics of general practice and promote the professional diversification of general practitioners，and establish a national unified platform for continuing education in general practice. More practical research and resources are needed to improve the training system of general practitioners in China in the future.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-06-19 Cooperative journals: 《中国全科医学》
Abstract： Medically unspecified disease (MUD) is a common problem in clinical practice. As a gatekeeper of health, it is a basic skill for every general practitioner to correctly identify and scientifically treat MUD at the first consultation. However, at present, workers and researchers in the field of general practice have different degrees of understanding of MUD, the diagnosis and treatment norms for MUD have not yet formed, and the scientific research related to MUD is relatively weak. The academic issue of "general practice and MUD" has become an urgent priority in the field of general practice in China. Therefore, this paper focuses on the "question of general practice" to organize a seminar for relevant experts to explore the "approach of general practice" to this issue. The discussion includes 6 modules: "Highlighting the Identification of General Practice: the Status Quo and Future of the Development of MUD in China", which involves the naming, development and future of MUD; "How to Carry out the Teaching and Training of MUD in General Practice", which involves training methods for students to correctly understand MUD, quickly identify "red flag signs" and "syndromes", improve capacity of physician-patient shared decision making and awareness of follow-up; "How to Carry out Scientific Research on MUD in General Practice Departments of General Hospitals", which covers the methods to carry out scientific research on the etiology and pathogenesis, diagnosis, intervention, prognosis, prevention and medical education of MUD; "How to Start with MUD by Reflecting the Characteristics of General Practice in City and County Hospitals", which covers the methods of opening MUD outpatient and inpatient wards in city (county) hospitals and improving the professionalism of general practitioners in the diagnosis and treatment of MUD; "How to Identify and Manage MUD Early by Community General Practitioners", which involves the management methods of pre-identification intervention, mid-identification treatment, post-identification treatment and long-term follow-up; "Hearing from the Side: Doctor-patient Communication in MUD", which argues that communication is the core of diagnosis and treatment of MUD, and analyzes patients' need for communication and doctors' reflections on communication. Each module is followed by hints of further research directions that scholars may consider, hoping to stimulate more specific researches in general practice in depth.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-03-15 Cooperative journals: 《中国全科医学》
Abstract： Background Medically unspecified disease（MUD）is characterized by complex and diverse symptoms that cannot be clearly diagnosed or rationally explained，which often leads to frequent hospital attendance，imposing a heavy economic burden on individuals，families and the healthcare system. Objective To understand the visits for MUD in general internal medicine clinics in county general hospitals by analyzing the results of a survey，providing a theoretical basis for standardized treatment of MUD by integrating evidence from this epidemiological survey and our ideas for general diagnosis and treatment of MUD in county general hospitals. Methods From January to March 2021，conditional sampling was used to select all patients（ n=45 439）who attended the general internal medicine clinic（85 881 visits in total）in a grade B tertiary county general hospital in Taizhou，Zhejiang Province from January 1 to December 31，2020 through the hospital information system.Among whom，adult patients with MUD were screened using the PRESUME screening method，and information involving the demographics，time of consultation and reasons for consultation was collected for analysis. Results A total of 497 adult patients were identified with visits due to MUD，with a mean number of visits of 2.23 visits/person，and a mean age at visit of （51.65±15.89）years. There were sex-specific differences in age composition and attendances of MUD patients（ P<0.01）. As for the reasons for visits，men had more visits due to anxiety than women（ P<0.05）. The visits due to abdominal pain， anxiety and cough differed significantly by age（ P<0.05）. The visits in different seasons showed no significant differences by sex and age（ P>0.05）. The visits for cough differed significantly across the seasons（ P<0.05）. Conclusion According to this survey，the visits due to MUD are influenced by various factors such as gender，age and season. Frequent visits for MUD due to various reasons cause difficulties in identifying and rationally treating the disease in the general internal medicine clinic as the first contact setting. To provide more accurate diagnosis and treatment for MUD patients，it is necessary to further develop the general medicine department，and make the general medicine department in county hospitals become the primary care center for MUD， and comprehensively enhance the effectiveness of county hospitals in serving the society.
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