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1.  Human immunodeficiency virus in drug misusers and increased consultation in general practice. 
The use of general practitioner services by a group of intravenous drug users was recorded over two two-year time periods 1984-85 and 1986-87. This was felt to represent the period of maximum change in awareness of human immunodeficiency virus (HIV) infection by patients and medical staff. Fifty patients were randomly selected: 25 who were HIV positive and 25 who were HIV negative. Between the two time periods a dramatic increase in consultation rate for both high risk and infected patients attending their general practitioner was recorded (318% and 172% increase, respectively). A small increase in attendance at the accident and emergency department (30% and 34% increase, respectively) was recorded for high risk and infected patients, and there was a large increase in attendance at the infectious diseases unit for infected patients but there was little effect on use of other hospital services. The implications for resource needs in the community are discussed.
PMCID: PMC1711873  PMID: 2558188
2.  Vocational training and recruitment into general practice 
A recent survey of doctors in the practice year of vocational training indicates a strong preference for group practice from purpose-built premises (health centre and other) with multidisciplinary staffing and attachments. While it might be assumed that the introduction of mandatory vocational training would provide a continuing supply of well trained recruits into general practice, it may well raise recruitment problems for those areas where practice facilities and opportunities do not meet with expectations. This possibility is of particular concern for those metropolitan regions encompassing inner city areas which have traditionally been highly dependent on hospital-based services, but where deficiencies in primary care provision, particularly in terms of practice structure and premises, have been identified repeatedly over the past 30 years. In view of the present policies for changing the balance of care away from the hospitals, there is an urgent need to develop primary care facilities which will accord with the expectations of vocationally trained general practitioners and their population of patients.
PMCID: PMC2159775  PMID: 7230105

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