Educating our patients, it’s more than skin deep

In general practice, we are continually trying to educate our patients, undertake preventative healthcare and empower our patients to take control of their health. But 15-minute medicine means we have to focus on what our patient needs most during the consult. Education is opportunistic most of the time, so how can we educate patients while still consulting on the patient’s primary concern?

The literature regarding preventative education in general practice is actually quite sparse, however, I was keen to know if we could use GP waiting room time to educate patients about preventative healthcare. After all, it’s common knowledge that some GPs tend to run very late!

I’ve been interested in dermatology since medical school, yet the lure of general practice was just too great so I’m very fortunate to have found my middle-ground and happy place….skin cancer medicine.

The rate of skin cancer continues to increase worldwide. The current RACGP guidelines advocate for screening if at increased risk and the RACGP Redbook, “Preventative Healthcare for GPs”, emphasises the importance of patient education about skin cancer and providing an opportunistic assessment. Yet, how do we translate this risk to patients and provide education?

This year as part of my academic registrar post at The University of Adelaide, which was funded by the RACGP, I have been looking at the way in which we are educating patients about skin cancer. Under the supervision of Professor Nigel Stocks and Associate Professor Jill Benson, I conducted a comparative pilot study looking at skin cancer education in general practice waiting rooms. This study would not have been possible without the support of Clare Medical Centre – Burra Clinic, Chandlers Hill Surgery, Gawler Medical Clinic and Unihealth Playford who all kindly donated their time and resources to this project. To all of the clinics mentioned above, I would like to take this opportunity to say thank you as well as the Cancer Council SA for the usage of their educational materials.

The analysis is still in the early stages, as multiple factors are being examined such as patient education on how to detect skin cancer and patient satisfaction regarding education but here is sneak peek at what we have seen so far. The project was primarily looking to see if posters in waiting rooms influenced patients to ask about their skin cancer risk. Currently, there is a lack of evidence to support the use of posters in GP waiting rooms and, perhaps unsurprisingly, this study uncovered that there was no statistical difference between having posters and not having posters in these areas.

The second stage of the study involved measuring what would happen if reception staff handed patients the skin cancer handout from the Cancer Council when they arrived at the clinic. Would that translate to the patient asking about their skin cancer risk or undertaking a skin check? The jury is still out on this, as overall across all four clinics there was no significant difference; however, some clinics had a stronger focus on skin cancer already and had a high uptake of patients already having skin cancer checks. Therefore, a more detailed analysis looking at individual clinics and other factors will now take place. It was, however, fantastic to see that 92% of the 653 patients sampled in this study found handouts from reception staff acceptable. These preliminary findings were presented as a poster at the RACGP’s annual conference, GP18, on the Gold Coast and I look forward to sharing the outcomes in 2019 when the study is hopefully published.

Research in general practice is an essential part of understanding what is best practice for our patients, although I have learnt throughout this year that GP clinic-based research is often time-consuming for doctors and administrative staff as well as financially unrewarding, but it must be stressed that in order for us to help our patients we need to know what does and doesn’t work in the clinic.

I am so grateful to GPEx who helped spread the word about my study to all interested clinics via YouTube, and I would like to acknowledge that I was only able to undertake such a project because of the support I received from the RACGP and Department of Health. I hope to continue conducting research in general practice, particularly when it involves focusing on preventative health care.

General practice provides so much scope for doctors to chose what interests them most whilst maintaining diversity and I’m lucky to have found mine – research and skin cancer!


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