Photo by Austin Distel on Unsplash

Hey friends! It has been a long while since I have last updated the blog. I am currently doing my final rotation of my foundation year which is general practice in the community setting for four months. It has been an enjoyable experience so far since I have started back in April. I do have to admit that initially I was rather overwhelmed by the vast difference in terms of managing patients in the community settings compared to secondary care setting such as the hospital. 

For example, as the resources are rather limited in GP setting as it should be, I found it hard to adjust to investigating patients' complaints and issues, While I can simply order all the blood tests and scans  that I want for patient with cough and breathlessness in hospital which comes by reflex, I was always reminded by my supervisors that "would the blood results and scans alter your course of management?". When I reflected upon this question, it came to my realisation that more often than not I have over investigated patients while I was treating them in the hospital. Having said that, there are various resources available in the hospital that it comes as second nature for us to fully utilise them to ensure patients are investigated and treated appropriately prior to disharge. 

Also another stark difference between secondary and primary care is the amount of time that I can spend on each patient. Naturally as second year of training junior doctor in the GP setting, I am allocated longer duration for each patient instead of the usual five minute slot for each patient for a standard GP. The trick to see patient in short period of time effectively without compromising patients' safety is to brush up both clinical and communication skills by performing focused history and examinations.

As of coronavirus situation at the moment, GP surgeries have changed consultation methods in order to prevent transmission of the disease and abide by the social distancing rules through telephone consultations. Basically I would do consultations with patients through telephone and in the event that I have concerns over patients conditions, I would either arrange a walk in appointments or home visits to examine them and manage accordingly, be it hospital admission or manage in community setting with safety netting.

Apart from seeing patients in the surgery, I would help the GPs to go through patients' blood results and referral feedbacks and act accordingly. If the blood results are too deranged needed urgent intervention, I would call the patient and ask them to present themselves to the nearest emergency department. After seeing all the patients and sorting out the documentations, blood results and referrals, I would call it a day and leave the surgery. Generally the working hours for foundation training doctors in GP surgery is 0900 till 1700 from Monday to Friday. Hope the information helps you to get further insight of the way general practice works. Cheers!