Read week

18

Hi Everyone!

Are you in touch with your spirituality? Do you know your cultural origins? Have you taken time recently to appreciate the variety of culture all around you?

This week is about Aboriginal health.

I had the privilege of doing my extended skills term in an Aboriginal Medical Service. As part of this 6 months, I learned an enormous amount about the history of the Aboriginal culture, the impact of what is called “settlement”,  and the way in which culture is kept alive today. I also learned a lot about the health gaps in this population with overall poorer outcomes in terms of dental care, heart disease, lifestyle disease and addiction. It really helped me understand why aggressive public health initiatives are in place to help address these issues.

Generally speaking, Aboriginal people have a unique understanding of traditional western medicine. This can cause issues in regards to adherence to treatment regimes and prevention behaviours. Aboriginal health workers provide a valuable bridge for this gap of understanding and can help the doctor-patient relationship to be much more beneficial.

An Aboriginal and Torres Strait Islander Health Assessment is a well-enumerated item number that adds great value to identify potential areas of future concern. When this is completed, it is important for the practitioner to take a thorough history of birth, development, health conditions, allergies, family history as well as a history of any current issues. Always remember to ask about sexual health, hearing, vision and dental health. A thorough physical examination should be completed, and appropriate referrals to dental services, hearing tests and allied health should be performed.

Look after yourself and remember to show respect for those of different backgrounds!

Dr Andrew Harris
Director of Amadeus Education.


Did you know?

According to BEACH data, 1.5% of all encounters in General Practice were with patients who identified as Aboriginal and/or Torres Strait Islander. Consider this as you are preparing for your exams. (Source: General practice activity in Australia: 2015-16. https://bit.ly/2c4d8Em)


Common conditions:

These are the common conditions that should be reviewed for this topic:

Topics

Important Resources

Lifestyle preventable disease – smoking, alcohol, drugs of addiction, obesity, poor dental hygiene, poor nutrition

  • Addressing high rates of smoking in remote Aboriginal communities: New evidence for GPs. July 2013, AFP. (https://bit.ly/2vwB4GI)

  • Outpatient alcohol withdrawal management for Aboriginal and Torres Strait Islander Australians. August 2014, AFP. (https://bit.ly/2VFVYBN)

  • National guide to a preventative health assessment for Aboriginal and Torres Strait Islander people. September 2018, RACGP. (https://bit.ly/2XV6ZfX) <–IMPORTANT

Common acute conditions – Acute rheumatic fever, otitis media

  • Rheumatic fever: Identification, management and secondary prevention. AFP, January/February 2012. (https://bit.ly/2GWajm3)

  • Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander Populations. 2010. (https://bit.ly/2IcpKai)

Common chronic conditions – Asthma, Type 2 Diabetes, COPD, Cancer, Hepatitis B, mental illness

  • Chronic hepatitis B: Care delivery and patient knowledge in the Torres Strait region of Australia. April 2013, AFP. (https://bit.ly/2V54bQE)

  • Mental health in Indigenous settings: Challenges for clinicians. January/February 2014, AFP. (https://bit.ly/2UQTfB5)

Indigenous men

  • Engaging Aboriginal and Torres Strait Islander Men in Primary Care Settings. Andrology Australia, March 2018. (https://bit.ly/2uEEB5m)

Antenatal care

  • Antenatal care for Aboriginal and Torres Strait Islander women. AFP, January/February 2014. (https://bit.ly/2JYvbfu)

Closing the gap

  • Aboriginal and Torres Strait Islander health: General practice embraces its significant role in closing the gap. January/February 2014, AFP. (https://bit.ly/2V8r7hE)

  • The Closing the Gap Initiative: Successes and ongoing challenges for division of general practice. July 2012, AFP. (https://bit.ly/2IRwR93)

  • Indigenous health: A role for private general practice. January/February 2011, AFP. (https://bit.ly/2ZVNBS2)

Culture

  • What do GPs need to work more effectively with Aboriginal patients? Views of Aboriginal cultural mentors and health workers. January/February 2014, AFP. (https://bit.ly/2GVzG6Z)

  • The practice of confidentiality in an Aboriginal medical service: What do GPs need to know? October 2009, AFP. (https://bit.ly/2GUpg7m)

Aboriginal Health Workers

  • The Aboriginal and Torres Strait Islander Health Worker Professional Practice Framework. July 2012, NATSIHWA. (https://bit.ly/2WlpZ7e)

  • Definition of an Aboriginal Health Worker. May 2018, NSW Government. (https://bit.ly/2PGDI5H)


Medication doses:

These are the medications and doses that should be learned for the exam:

Condition

Medication

Acute rheumatic fever

  • 900mg IM single dose (kids <20kg: 450mg)


Mnemonics:

These are some important mnemonics relevant to this topic:

  • Jones criteria (acute rheumatic fever diagnosis)

CHECKS:

Here are the list of recommended Checks that would be useful in your study for GP exams (accessed via subscription from http://gplearning.racgp.org.au):

  • Vulnerable populations, October 2017
  • ATSI health, August 2011

Focus on clinical skills:

Here is a brief focus on some OSCE preparation topics related to this topic:

  • Discussing chronic disease with Aboriginal or Torres Strait Islander patient.

Copyright © 2021 Andrew Harris