What I didn’t say was that most case reports and picture quizzes published so far are aimed particularly at hospital doctors rather than primary care doctors (GP’s/family physicians).
We would like to make Endgames relevant for GPs too, which is why we want to start a new series of Endgames case reports and picture quizzes that will specifically address the learning needs of GPs in training. We want to try keep a similar format (clinical vignette, questions with short and long answer, and patient outcome) but we’re well aware that the types of questions will need to be different in order to cater for the particular circumstances of primary care practice, where doctors attend to patients in earlier stages in the natural history of disease and thus face much more uncertainty regarding diagnosis and management, deal with patients with multiple co-morbidities and complex social and family problems, access to exams is much more limited than in hospital, and management often just relies on just history taking, physical examination and good judgement.
Finally, don’t forget that GP’s don’t always make formal diagnoses. So we will be looking for questions in case reports and picture quizzes like, just to give a few examples, “What do these clinical findings mean?,” “Are there red flags?”, “Should you refer this patient?”, “Is the patient’s social and family history relevant in this case?” or “What advice would you give to patients or relatives?”
All articles will be peer reviewed, and we can’t of course guarantee publication. But if you are a GP trainee or a GP, and are interested in writing case reports or picture quizzes, then I would like to hear from you
Moreover, the latest NICE guideline summary, on diagnosis and management of community and hospital acquired pneumonia, offers a lot of useful advice to GPs. I found the part about identifying patients presenting with symptoms of lower respiratory tract infection who may, or may not benefit from antibiotic therapy, particularly useful, even though it requires access to point of care C reactive protein tests, which may not be available locally. The other relevant bit for GP’s of the guideline summary is the CRB65 score, that is intended to help the GP ascertain whether patients with a suspected community acquired pneumonia should be treated at home or in hospital.
Creating more relevant content for GPs is one of The BMJ’s wishes for the New Year.
Tiago Villanueva is assistant editor, The BMJ.