Role of a family doctor in health care

Family medicine is a discipline only recognized by this name in the USA, Canada and India. In other parts of the world and especially in Europe, it is known as general practice.

Role of a family doctor

In general, family doctors may start their day at their office seeing patients. They may treat people with conditions ranging from minor, such as the flu, to serious diseases including heart disease and cancer.

Family practice doctors take medical histories, perform physical exams, and order diagnostic tests. They also spend part of their time reviewing labs, x-rays and other tests to make a diagnosis and come up with a treatment plan.

In some instances, a family practice doctor is the first medical professional a person sees when they have symptoms. One important responsibility of a family practice doc is to consult with other specialists when needed. For example, if a patient comes in with signs of cancer, a family practice doctor may coordinate care with an oncologist. In addition to seeing patients in their office, family practice doctors also usually spend part of their day seeing their patients who are hospitalized.

Benefits 

One cool aspect of being a family practice doctor is you may see patients even when they are not ill. Part of your role is to help people prevent illness and stay healthy. For instance, family practice doctors often recommend regular checkups and routine health screenings to spot minor issues before they become serious. Doctors also spend time teaching patients about healthy lifestyle choices, disease prevention and provide information for people to take control of their health.

Family practice doctors are either in private practice or work as part of a group practice.  Salaries for family practice doctors vary depending on what part of the country they live in and how much experience they have. According to the United States Bureau of Labor Statistics, on average, family practice doctors earn about $195,000 a year.

One good thing about choosing family practice is experts predict there will be a lot of opportunities in the future. As medicine changes, more specialties emerge.  Less med school grads are going into family practice, which means there is a shortage of doctors in this specialty.

If you like the idea of having a longstanding relationship with patients, treating various conditions and working with a diverse patient population, becoming a family practice doctor may be the perfect fit!

OSTEOARTHRITIS : Treatment and management

Osteoarthritis is the most common form of joint disease and the pain it causes is severe and can last lifelong. It was earlier seen especially among older people, but now more and more young people are falling prey to osteoarthritis.

Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs. The disease mainly affects the joint cartilage and the bone tissue next to the cartilage. The most commonly affected joints are hands, knees, hips, big toes and spine.

What causes osteoarthritis?

The exact causes of osteoarthritis are not known but there are multiple factors thought to cause this disorder. Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

  • Pain in joints
  • Tenderness in joints when applying pressure
  • Stiffness in joints after sleep or after rest.
  • Swelling in joints
  • Loss of flexibility and inability to move joints
  • Crepitus, or a grating sensation when the joint moves
  • Bone spurs or bony growths around the affected joint

Risk factors that may lead to osteoarthritis include:

  • Obesity – Being overweight increases the risk for osteoarthritis
  • Age – Commonly prevalent in people over 50 years
  • Gender – More women than men have
  • Injury to the joint –Previous injuries received while playing sports or from an accident
  • Bone deformities – People with previous joint injury or surgery, or abnormal joint alignment
  • Physical demanding occupations – Jobs that place repetitive stress on a particular joint
  • Other diseases- People with rheumatoid arthritis are more likely to develop osteoarthritis

How is osteoarthritis diagnosed?

There is no single test for the diagnosis of osteoarthritis. Your doctor can often diagnose osteoarthritis based on a combination of factors including your medical history, physical examination, X-rays and other tests such as examinations of the fluids in the joint.

X-Rays

X-rays of the affected joints can help doctors determine osteoarthritis. The common X-ray findings of osteoarthritis include cartilage loss, bone damage, and bone spurs formation. However, X- rays may not show early osteoarthritis damage until much cartilage loss has taken place.

Magnetic Resonance Imaging

Magnetic Resonance Imaging (MRI) provides high-resolution computerised images of internal body tissues. It can be especially helpful in evaluating the joint damage. Doctors often use MRI tests if there is pain or if X-ray findings are minimal and if the findings suggest damage to other joint tissues such as a ligament or the meniscus.

Arthrocentesis

Arthrocentesis, or joint aspiration, is a procedure done to obtain fluid for diagnostic lab testing to relieve joint pain, swelling and inflammation. During the procedure, a sterile needle and syringe are used to remove fluid sample from the joint for analysis.

Arthroscopic Surgery

Arthroscopic surgery is commonly recommended for middle-aged or older people with persistent knee pain. It is a surgical method where the surgeon makes a small insertion and inserts the arthroscope, a pencil-sized instrument that contains a light and magnifying lens. The arthroscope is attached to a tiny camera that allows the surgeon to see the inside of the joint. The surgeon can then detect abnormalities of and damage to the cartilage and ligaments and remove loose bone or cartilage pieces that may be causing pain and inflammation.

How is osteoarthritis treated?

There is no known cure for osteoarthritis. Patients suffering from osteoarthritis often live with severe pain and have significant difficulty in carrying out normal daily activities. Therefore, most treatments are focused on pain reduction and overall patient functioning.

Symptomatic slow-acting drugs (SYSADOAs), non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and intra-articular injections such as cortisone and hyaluronic acid directly into the knee joint may relieve pain in some people with osteoarthritis. In those patients in whom medications fail, referral to an orthopedic surgeon should be considered.

As the number of people suffering from osteoarthritis increases every year along with the aging of the population and the growing problem of obesity, the urgent need for newer and more effective osteoarthritis treatments will continue to expand. Research is being done on osteoarthritis including on tools to detect osteoarthritis earlier and in developing medicines to prevent, slow down, or reverse joint damage.

Understanding and managing neck pain

People often attribute neck pain is muscle sprain. But it need not be so, you need to know why exactly there is a neck pain and seek medical help for treatment/ pain management if it occurs frequently.

If a person in his/her forties or fifties experiences neck pain, and routine pain killers aren’t helping, than the doctor would typically check for radiating symptoms. Radiating symptoms occur when pain travels to the shoulder or arm, or there is any associated numbness, tingling, weakness in the arms. This is an important symptom as there might be a problem with nerve (s), such as a pinched nerve.

If the patient only has neck pain minus the radiating symptoms, then the doctor, based on whether the pain occurs during night or morning and the patient’s social history, will determine the cause of the problem, taking into consideration their lifestyle and work pattern, including posture. The reflexes, muscle power, sensation in the neck and surrounding areas such as shoulder, elbow and wrist are also checked.

If the pain is constant at night or weakens the person in the middle of the night, it can be a cause of concern as it might be linked to any systemic illness, such as diabetes, cancer or other such illnesses.

Some of the common neck pain treatment methods include:

  • non-surgical neck pain treatment
  • conservative neck pain treatment
  • neck immobilisation
  • supplemental treatment for conservative neck pain management

Since neck pains are usually caused by sudden trauma like muscle strains or sprains, treatment usually begins with conservative care in the form of medications, physical therapy, heat/ice therapy and muscle conditioning. Degenerative issues, lack of exercise and improper posture are also causes of neck pain.