Volume 6 Issue 3 - 2012
A week is a long time in politics! Barely had my pen dried on the last editorial, focusing on the Health & Social Care bill entering the statute books and we are suddenly presented with a new array of politicos in Health.
Jeremy Hunt has been passed the political poison of the Department of Health. The Prime Minister probably needed to move aside the rather dour Andrew Lansley, whose mere facial appearance managed to upset all levels of health service, even before he opened his mouth. Hunt seems more approachable and likeable because he has a sniff of fallibility, and therefore humanity, about him. This quality, coupled with some humbleness, will endear him to the public and professionals alike and keep the reforms from totally derailing.
Abstract Respiratory diseases account for a large proportion of the primary care workload. This article reviews five cases referred to our chest clinic from primary care highlighting five common clinical problems encountered by general practitioners. The first section begins with a discussion of the options available to prevent recurrent exacerbations of COPD. Palliation of breathlessness in advanced respiratory disease is a difficult clinical problem and the role of anxiolytics, opioids and oxygen therapy are discussed. Chronic cough is one of the most common chronic respiratory problems encountered by GP’s and this case is used to highlight the various steps in investigation and empirical management of this difficult problem. Finally, a lady with recurrent respiratory tract infections and asthma in pregnancy are reviewed and discussed.
GPs are increasingly at the forefront of providing palliative care in the community. Identifying those patients who should be on the palliative care register, especially those with nonmalignant diseases, managing their symptoms such as pain, addressing difficult questions and anticipating and planning ahead for potential problems can all be challenging but can make a crucial positive impact on these patients and their families.