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International Primary Care Association

Clinical Focus Volume 2 N2

Volume 2 Issue 2 - 2006


The increasing sub specialisation of hospital consultants is inevitable as postgraduate training shortens and our individual clinical results become available. In this article I argue that this specialisation disrupts the care of a patient with vascular disease. The same atherosclerotic disease process may result in a patient attending secondary care to see: cardiologists, vascular surgeons, nephrologists, stroke physicians and hypertension teams. These specialists will be in separate Directorates and are unlikely to communicate well with each other. The GPwSI in Vascular Disease is ideally placed to conduct this talented but disparate orchestra of Hospital Specialists! Nor need the GP feel isolated -the proposed new role of Medical Care Specialist (UK version of the American Physicians’ Assistant) could support their work ( workforce/practitioners/medical/default.aspx).


This article is based on part of the Postgraduate Diploma of Minor Surgery ( In it I look at the standards required, the theory behind sterilisation, and the practical application of those theories. I have attempted to produce an easily understood guide that will allow the Practitioner with Specialist Interests to know what standards to achieve, how to achieve them and to understand why they must be achieved.


Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous ducts which can cause significant psychological distress. The majority of patients are seen and treated in primary care. This article reviews the different systemic therapies currently available for acne in both primary and secondary care. We outline the indications for use, duration of treatment and side effects of commonly used oral agents. Criteria requiring referral to specialist dermatological care are discussed.


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