Personal Views

Evidence based general practice

BMJ 1997; 314 doi: (Published 15 February 1997) Cite this as: BMJ 1997;314:525
  1. J P Richards, general practitioner
  1. Merthyr Tydfil

    We were talking over coffee and agreed that the management of uncertainty used to be the greatest art of general practice. My first consultation after coffee was with Michael. He came to tell me how he had been getting on. Six months ago he had consulted with a cough and a cold. He was a healthy 73 year old who rarely consulted the doctor.

    Our health promotion targets were looking beyond our reach and I knew that I ought to take this opportunity to check his blood pressure. It was 192/95 mm Hg. His experiences following that finding have led me to reflect on the art of modern general practice. This can be encapsulated as: “patient centred, evidence based, effective, efficient, appropriate, and acceptable care provided within a primary care led National Health Service.”

    This is what has happened to Michael as I have endeavoured to provide such a service for him. Our nurses checked his blood pressure four times to establish the “diagnosis” of systolic hypertension. …

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