GP education: small & slow steps

By Dr Irwin Lim, Rheumatologist

Last night, a few of our clinic's rheumatologists spoke at an after-hours GP education meeting. The attendance was poor, with 8 showing up after a number RSVP'd and did a no-show.

It didn't matter. We were more than happy with an intimate setting. We presented a number of case studies to help raise awareness of rheumatoid arthritis, psoriatic arthritis and spondyloarthritis. We structured the discussion and questions to highlight take-home messages in disease management.

I was a little disappointed to find out the following:

• Nail changes of psoriasis were not something the GPs associated with psoriatic arthritis
• None could recognise dactylitis (sausage digit), a key clue in the diagnosis
• Few seemed to recognise features differentiating mechanical from inflammatory back pain

The job of a GP is very difficult with so much to keep abreast of, and so many messages from different speciality groups.

But, it was worrying that not one of the GPs was aware of biologic treatment - the major therapeutic advance in the last decade in rheumatology.

This is something that needs to change. GPs will not be prescribing these medications but it is important that they are aware of their existence, and the potential benefit for at least some of their patients.

Our major message was to highlight that arthritis is often not a benign condition and that early referral for an accurate diagnosis was important for the patient. A diagnosis can help patients cope and allow them to be educated about the condition. The appropriate treatment for their particular circumstance can then be instituted.

I hope this message got through.