Murtagh’s Practice Tips is a collection of basic diagnostic and therapeutic skills that can be used in the offices of general practitioners throughout the world. The application of these simple skills makes the art of our profession more interesting and challenging, in addition to providing rapid relief and cost-effective therapy to our patients. It has been written with the relatively isolated practitioner, doctor or nurse practitioner in mind. This means that a broad range of more complex procedures involving some degree of improvisation will be covered.
The art of medicine appears to have been neglected in modern times and, with the advent of super-specialisation, general practice is gradually being deskilled. I have been very concerned about this process, and believe that the advice in this book could add an important dimension to the art of medicine and represent a practical strategy to reverse this trend. The tips have been compiled by drawing on my own experience, often through improvisation, in coping with a country practice for many years, and by requesting contributions from my colleagues. Doctors from all over Australia have contributed freely to this collection, and sharing each other’s expertise has been a learning experience for all of us.
I have travelled widely around Australia and overseas running workshops on practical procedures for the general practitioner. Many practitioners have proposed the tips that apparently work very well for them. These were included in the text if they seemed simple, safe and worth trying. The critical evidence base may be lacking but the strategy is to promote ‘the art of medicine’ by being resourceful and original and thinking laterally.
Many of the tips have previously been published in Australian Family Physician, the official journal of the Royal Australian College of General Practitioners, over the past decade or so. The series has proved immensely popular with general practitioners, especially with younger graduates commencing practice. The tips are most suitable for doctors working in accident and emergency departments. There is an emphasis on minor surgical procedures for skin problems and musculoskeletal disorders. A key feature of these tips is that they are simple and safe to perform, requiring minimal equipment and technical know-how. Regular practice of such skills leads to more creativity in learning techniques to cope with new and unexpected problems in the surgery.
Several different methods to manage a particular problem, such as the treatment of ingrowing toenails and removal of fishhooks, have been submitted. These have been revised and some of the more appropriate methods have been selected. The reader thus has a choice of methods for some conditions. Some specific procedures are more complex and perhaps more relevant to practitioners such as those in remote areas who have acquired a wide variety of skills, often through necessity. This seventh edition continues the emphasis on emergency procedures, particularly for acute coronary syndromes and on wound management.
It must be emphasised that some of the procedures are unorthodox but have been found to work in an empirical sense by the author and other practitioners where other treatments failed. The book offers ideas, alternatives and encouragement when faced with the everyday nitty-gritty problems of family practice, particularly in rural and remote practice. Evidence based medicine has been included where appropriate with helpful input from the RACGP’s HANDI project who have given permission to use references for practice tips that have been published in that series of papers in Australian Family Physician.