Volume 2 Issue 1 - 2006
Limited resources in the NHS is nothing new, but the recent changes and drives from the Department of Health have had a significant impact on the relationships between doctors in primary and secondary care, as well as the roles and services provided. With great change brings great opportunity. Large egos need to be placed aside as we as a profession take this opportunity to work closely together as a unified team. Most would agree that good teamwork is essential for success, and that respect for all members of the team is paramount. One of us still remember the first clinical attachment at medical school when the Professor of Medicine spoke of the importance of dignity, not only in relation to the patients we treat, but also to those with whom we work. “Do not underestimate anyone in the team”, he said, “not even the cleaners, for without them our workplace would not be safe enough to see patients, and without patients we would be without a job!”
Presenting as anogenital warts, the human papillomavirus (HPV) is the most common viral sexually transmitted infection diagnosed in the United Kingdom (UK). General Practitioners with Special Interests (GPwSIs) that include Sexual Health should be able to manage this common and often frustrating condition. Not routinely requiring partner notification and being diagnosed almost exclusively on clinical appearance, with options for patient selftreatment, genital warts in most cases, lend themselves ideally for management in a primary care setting.
GPwSIs should have knowledge of the homebased treatments and be competent in the use of at least one office-based method. They should be able to advise patients appropriately, perform routine screening tests for sexually transmitted infections and know when to refer to a specialist centre.
Practitioners with a special interest in breast diseases will provide effective triage for symptomatic women. After training, by maintaining skills in breast examination they can identify those in need of hospital assessment and reduce the number of unnecessary referrals, particularly for mastalgia, nipple discharge and non-significant family history.