Problem Solving Problem Solving andand Patient Management Patient Management

in in Family PracticeFamily Practice

Problem Solving Problem Solving andand Patient Management Patient Management

in in Family PracticeFamily Practice

Prof. Adnan Ahmad AlbarProf. Adnan Ahmad Albar

الرحمن الله بسمالرحيم

Introduction

Reasons for seeing the doctor include

Management in general practice

• Assessing the pt.• Planning treatment• What are the risk and benefits of

treatment• Negotiating with the patient• Monitor progress• Making referral

Five major tasks to Dx & Rx undifferentiated undiagnosed

problem

Difficulty in constructing problem list

Examination in General Practice

What about diagnosis in general practice?

Level of Diagnosis

Effective use of diagnostic and therapeutic intervention

• This will require1- Knowledge of positive and negative predictive

value of symptoms and signs and finding from ancillary tests obtained in clinical data collection , and their dependency on the prevalence of the target disease

2- Understanding of cost – efficiency and cost-benefit of tests and treatment , and the number needed to treat or harm for specific treatments .

Deciding whether to request a test

The specific decision-making process to prevalence and incidence of

illness in the community• this will require :1- Knowledge of illnesses and diseases in

primary care , including their specific incidence and prevalence .

2- Knowledge of practice population ( age-sex distribution , prevalence of chronic diseases )

- Skill to apply specific decision –making ( using tools such as clinical reasoning and decision rules ).

The predictive value positive of a test is the probability that the pt. with a positive test has the disease .

Interpreting Diagnostic Test Result

Who’s for screening?

Intervene urgently when necessary

• This will require 1- Specific decision-making skills for

emergency situation

2- Specific skills in emergency procedure in primary care situation

Guidelines and protocol

Management in general practice

• Assessing the pt.• Planning treatment• What are the risk and benefits of

treatment• Negotiating with the patient• Monitor progress• Making referral

Thank You