Questions for general practice

doi:10.1136/bmj.326.7399.1134-a

BMJ 2003;326:1134-1135 (24 May), doi:10.1136/bmj.326.7399.1134-a

Commentary

Questions for general practice

Alistair Howitt, general practitioner¹

¹ Warders Medical Centre, East Street, Tonbridge, Kent TN9 1LA ajhowitt@warders.co.uk

The first 150 words of the full text of this article appear below.

Tudor Hart describes the real stuff of primary medical careas the steady unglamorous slog of anticipatory care, wherethe exciting things have been events that have not happened.¹When acute events do occur, as in this case, the electronicresponses from Bossano and Trivanovic rightly highlight thedifficulties in diagnosing chest pain in the community withoutaccess to sophisticated investigations.²

Good consultation skills are always important. Peter Hartl'sdescription of his pain before admission is in itself a sensitivetest for acute thoracic aortic dissection.³ His inabilityto explain why he did not seek help immediately is interesting. In myocardial infarction, patients' delay in calling for helphas been described as the weakest link in the chain of survival.The most critical factor is the recognition that the symptomsare cardiac in origin.⁴ Should part of our education for patientsat high risk of acute cardiovascular emergencies include how. . . [Full text of this article]