Volume 47, Issue 5, May 2018

The heart of the matter

Glenn Duns   
doi: 10.31128/AJGP-03-18-1234e   |    Download article
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Our ability to reach unity in diversity will be the beauty and the test of our civilization.

– Mahatma Ghandi

Society is unity in diversity.

– George Herbert Mead

The recent renaming of the journal from Australian Family Physician to Australian Journal of General Practice (AJGP) presents an opportunity to reflect on the varied nature of general practice and the related challenge of publishing articles for such a heterogenous audience. A general practitioner (GP), by definition, must be able to diagnose and treat a very broad range of conditions, and there are also many GPs who develop specific interests and may pursue additional training in areas such as obstetrics and gynaecology, emergency medicine or men’s health. Some GPs are primarily academics and have a keen interest in the publication of research. Others have a passion for public health, or may be primarily administrators. How does one choose articles for such a diverse audience? What about the numerous overseas readers, or the readers who are not medical doctors? Do they warrant consideration as well?

Compare this situation with specialties that focus on a particular organ system, age group or gender. The range of articles in their associated journals will be narrower, and the readership more homogenous and more likely to have a particular article fall within their area of interest.

A primary care journal such as AJGP, on the other hand, will almost inevitably have individual readers who find some articles much more interesting than others. One reader may have a great interest in an article on common neonatal problems, while another reader who mainly practises in aged care would have no such interest. In addition, as the articles in AJGP are often meant to address grey areas of medical practice and not simply be a summary of textbooks and guidelines, there will also be differences in opinion regarding treatment recommendations. 

In this issue of AJGP, we present a range of articles on the cardiovascular system; each article is likely to appeal to different readers for different reasons. Stevensen and Voskoboinik have provided a comprehensive and informative article on cardiac rhythm management devices, including practical advice for patients on matters such as electromagnetic interference and sexual intimacy.1 Thomsett and Cullen cover the assessment and management of chest pain in primary care,2 a common presentation that has potentially life-threatening consequences. Chuen and Theivendran present two articles on abdominal aortic aneurysms. The first article is a detailed summary of current treatments3 and the second is on screening and surveillance, with consideration of public health issues.4

What is the heart of general practice, something that all readers of the journal will consider relevant and of interest? Is it the provision of comprehensive, coordinated care that is well suited to addressing the complex and growing challenge of multimorbidity,5 or a detailed knowledge of zoonotic diseases?6 Is it a confident grasp of common mental health conditions?7,8 The answer, of course, is all of the above insofar as they are concerned with the care of the patient, a unique individual with a unique history, biology and environment and a range of qualities both objective and immeasurable.

The mission statement of AJGP focuses on the heart of general practice: support and encouragement for GPs to deliver the highest quality care for their patients. Importantly, this goal extends across the entire range of logistic, geographic and sociocultural domains in which GPs work everyday. The articles published in AJGP reflect this breadth of practice. I hope that we can continue to recognise and appreciate each other in all of the diverse roles within our medical society that serve to fulfil the unified goal of high-quality patient care.

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  1. Stevenson I, Voskoboinik A. Cardiac rhythm management devices. Aust J Gen Pract 2018;47(5):264–71. Search PubMed
  2. Thomsett R, Cullen L. The assessment and management of chest pain in primary care: A focus on acute coronary syndrome. Aust J Gen Pract 2018;47(5):246–51. Search PubMed
  3. Chuen J, Theivendran M. Abdominal aortic aneurysm: An update. Aust J Gen Pract 2018;47(5):252–56. Search PubMed
  4. Theivendran M, Chuen J. Updates on AAA screening and surveillance. Aust J Gen Pract 2018;47(5):259–63. Search PubMed
  5. Harrison C, Siriwardena AN. Editorial: Multimorbidity. Aust J Gen Pract 2018;47(1–2):7. Search PubMed
  6. Eastwood K, Massey PD, Mor SM, Boward K. Editorial: Unravelling zoonotic diseases in Australia. Aust J Gen Pract 2018;47(3):85. Search PubMed
  7. Buist A. Perinatal mental health: Identifying problems and managing medications. Aust Fam Physician 2014;43(4):182–85. Search PubMed
  8. Kyrios M, Moulding R, Nedeljkovic M. Anxiety disorders: Assessment and management in general practice. Aust Fam Physician 2011;40(6):370–74. Search PubMed

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