Gynaecology in Primary Care comes at a time of great change in health service delivery. General practice is facing the challenges of developing Clinical Commissioning Groups, providing an ever greater range of primary care services and implementing NICE guidelines, whilst CCGs through their members will be under a legal duty to innovate. From a provider perspective, the book equips general practitioners with up-to-date knowledge of common gynaecological conditions, suggestions of best practice with regard to management and investigations to be undertaken within primary care, and guidelines for onward referral, where this is appropriate and necessary. From a commissioning perspective it provides an invaluable resource to CCGs, to inform their future pathways for gynaecology care. This highly practical book delivers the main aim of the RCP report - to ensure best care for female patients in the setting of their choice and where possible to develop streamlined one-stop services in primary care so that women do not have to take time off from their work and family commitments. It is ideal for general practitioners needing to be inspired and informed, and is also highly recommended for other healthcare professionals and medical students with an interest in women's health. 'Optimal patient care requires many connected features to synchronise effectively. This book describes how this could be achieved by focusing attention on well-crafted, evidencebased clinical pathways. This book advances our thinking on how we connect clinical, system and patient level perspectives on optimal care management.' Denis Gizzi, in his Foreword 'Written by a highly regarded, experienced and practicing GP, who has taken on the role as Clinical Director on behalf of the CCG for this programme area, this book is a valuable asset for both practicing GPs and developing CCGs to ensure that gynaecology services effectively commission, maximise the health of the population, improve the experience of the patient, and improve value for money.' Kath Wynne-Jones, in her Foreword 'An excellent guide to the management of gynaecological problems in primary care for not only clinicians in training, but for more experienced clinicians who look for straightforward and easily accessible advice to support their clinical management decisions. Look no further than this textbook. Dr Sharma's textbook will be a boon to developing organisations in delivering world-class services.' Dr Ian Wilkinson, in his Foreword

Despite the common perception that medicine is becoming specialty driven, there are many reasons for primary care providers to offer women’s health procedures in an office setting. Women feel more comfortable having procedures done by prov- ers whom they already know and trust. Continuity of care is still valued by patients, who trust their primary care providers to work with them as collaborators in the decision-making process. Women have found that their options for care have become limited, not by their own decision, but by the lack of training of their p- vider. In rural areas, the barriers of time, expense, and travel often prevent many women from obtaining necessary care; yet many of the procedures that these women are requesting are relatively easy to learn. Positive experiences are shared by women who then refer friends and family by word of mouth. This book has been designed to assist not only the clinician performing the pro- dures covered, but also the office staff with setting up the equipment tray prior to p- forming the procedure and with preparing office documents and coding information needed to complete the procedure. Most procedures covered can be done with a mi- mum investment in equipment and require minimal training.

"Adolescent sexuality and gynecologic care of young patients are topics which make most clinicians uncomfortable. This is due to a lack of knowledge and training in many circumstances. Assumptions based upon knowledge of adult gynecology alone may be hazardous for pediatric and adolescent patients. These children and young women often do not have access to specialists who are able and willing to care for their gynecologic issues at an appropriate level. The primary care setting is often the most comfortable venue for a number of these patients. The concept for this book was to provide a reference for primary care providers without highly specialized gynecology textbooks, just to focus on what providers tackle on a daily basis. The first edition was well received and the feedback was good. In the 10 years since the first edition was published, our knowledge has improved and many new methods, medications and devices were added to daily practice. Those changes prompted the Editors to provide an updated version of the book, while keeping its essence intact"--

This text presents primary care information for the nurse-midwifery scope of practice, including management of primary care problems in essentially healthy women, and the management/coordination of primary care for pregnant women with significant, established medical conditions. The text covers prevention, including lifestyle changes and immunizations; screening; management of common health problems appropriate to nurse-midwifery practice; and the presentation and management of common health problems in pregnancy.

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family. Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding. Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion. A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text. A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting. A new section details which immunizations can be used safely during pregnancy. A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.