Lam Tai Pong

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Title How do we research on questions related to general practice?Author(s) Lam Tai PongCitation Hong Kong Practitioner, 1997, v. 19 n. 4, p. 169-170Issued Date 1997URL http://hdl.handle.net/10722/45034Rights Creative Commons: Attribution 3.0 Hong Kong LicenseThe Hong Kong College ofGeneral Practitioners8th Floor, Duke of Windsor Building,15 Hennessy Road, Hong Kong.Tel : 2528 6618 (2 Lines)Fax: 2866 0616Website:http://medicine.org.hk/hkcgp/journal.htmEDITORDr. Lam Tai PongDEPUTY EDITORSDr. David VK. ChaoDr. Wong Hung WaiBOARD MEMBERSDr. Cynthia S.Y. ChanDr. Chan Wai SunDr. Stephen ChenDr. Nelson K.H. CheungDr. Rudolph W.M. ChowDr. Julie CohenDr. Kwok Kon HungDr. Augustine T. LamDr. Cindy L.K. LamDr. Lam Tai KwanDr. Lam YuenDr. Bernard WK. LauDr. Frederick C.T. LeeDr. Glenn K.L. LeeDr. Peter C.Y. LeeDr. Lawrence K.C. LeungDr. Ronson C.T. LiDr. John MackayDr. Charles C.Y. NgDr. Ng Chun BorDr. David OwensBUSINESS MANAGERDr. Betty K.M. KwanADMINISTRATIVE MANAGERMs. Teresa LeeEDITORIAL ADVISERSProf. Cindy S.T. AunProf. Augustine F. ChengProf. Tony DixonProf. Wes FabbProf. S.T. FanProf. A. HedleyProf. Walter W.K. KingProf. C.R. KumanaProf. C.P. LauProf. S.H. LeeProf. EC. LeungDr. Mak Ki YanProf. C.W OgleDr. Wilfred C.G. PenProf. Grace TangProf. Mark TsoProf. C.A. Van HasseltProf. Jean WooProf. C.Y. YeungProf. R.T.T. YoungSTATISTICAL CONSULTANTSDr. Joseph LauDr. Ian LauderThe Hong Kong Practitioneris indexed in Excerpta Medica(EMBASE).Printed & Designed ByPrinthouse Production CenterHong KongEDITORIALHow Do We Research OnQuestions Related To GeneralPractice?The paper by Chan1 published in this issue of the Journal providesuseful information on upper respiratory tract infection (URTI), the bread andbutter illness seen in general practice. It helps to confirm that most patientsprefer doctors who are active listeners and who also educate them abouttheir illnesses.2 In another recent article, Chan provided data to disperse themyth that patients in Hong Kong expected antibiotics for URTI, insteadwhat they do expect is medication to relieve their symptoms.3 These arevery important findings because over one third of all general practiceconsultations in Hong Kong are primarily for URTI. There lies significantmedical, social and financial implications in these data.However, despite claims by 60% of the respondents of knowledge ofself management of URTI in Chan's study, half of them consulted theirdoctors within the first two days of their illness. There existedcontradictions in what many of the respondents claimed and what theyactually did. It is not unusual for surveys of this type to have findingswhich may not appear to be very logical. How do we go about exploringthis very complex human behaviour?General practice is different from other medical disciplines. It is morethan just pure medical science. The Alma-Ata Declaration states thatprimary health care reflects and evolves from the economic conditions andsociocultural and political characteristics of the country. General practice isarguably a medical-social science.Professor G Stephens has said, "The content of general practice is theordinary more than the extra-ordinary, the common more than the rare. It ison the problem more than the disease, the organism more than the cell."General practitioners deal with patients in the community and most of theconsultations are initiated by patients whose problems may have significantpsycho-social origins. Using URTI as an example again, only 7.1% of allgeneral practice encounters in Australia4 are for URTI but 33% in HongKong. What might account for the difference?We all know that URTI is a minor and self-limiting condition and,therefore, it is highly likely that psycho-social reasons play a major part in169EditorialEDITORIALthe difference as to why many patients consult theirgeneral practitioners for URTI in Hong Kong but not inAustralia.In order to investigate this very complex humanbehaviour, the addition of qualitative researchmethodologies such as in-depth interviews andobservations will allow the development of a researchbase for the discipline that matches its practice and itsvalues, and opens up new questions to research.5 We,general practitioners, attempt to allow clinicalinformation to speak for itself in our daily work,listening sufficiently to our patients to let them tell uswhat is wrong. This is similar to the qualitativemethods used in natural sciences to describe the naturalworld and the narrative description of many diseases,e.g. diabetes and measles when they were first detailedmany hundred of years ago.Qualitative and quantitative methods need not bemutually exclusive. Their applications are to bedependent on the nature of the research question.Qualitative research methods are, however, particularlyuseful to explore complex human behavioural issues,like the one that has been raised by Chan in her article.As pointed out by Griffiths and Marinker, "Ifresearch in general practice restricts its enquiry toquestions that can only yield to numerate research, itwill be unable to explore beyond current traditionalconcepts that determine and delimit what questions canbe asked." We are then not taking advantage of the realedge we have over many other medical disciplines. |Lam Tai PongEditorReferences1. Chan CSY. Patients' preferences at consultations for upper respiratorytract infections. HK Pract. 1997; 19(4): 171-182.2. Lam TP. What is a "doctor". HK Pract. 1994; 16: 537-538.3. Chan CSY. What do patients expect from consultations for upperrespiratory tract infections? Fam Pract 1996; 13: 229-235.4. Bridges-Webb C, Britt H, Miles DA, et al Morbidity and treatmentin general practice in Australia 1990-1991. Med J Aust 1992; 157(19Oct Spec Suppl): S1-S56.5. Griffiths F & Marinker M. Exploring qualitative research in generalpractice: introduction. Fam Pract 1996; 13: S5-S6.170

How do we research on questions related to general practice?

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How do we research on questions related to general practice?

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