Hepatitis C: the "advanced consultation", a way to train general practitioners to support disease

In the "advanced consultation" Hepatitis C is one of the ways to train GPs in the management of the disease, said an expert at the conference of the Federation SOS Hepatitis.

The subject of the management of hepatitis C in the city by general practitioners is even more important than the health minister, Xavier Bertrand, has expressed his hope that the management will do 60% city and 40% in hospital, while the opposite is true today.

Federation SOS Hepatitis patients organizes its 8th Paris Forum. A round table was devoted to innovative experiences in the management of hepatitis C.

Dr. Nathalie Boyer, hepatologist at the Beaujon Hospital in Clichy (Hauts-de-Seine, AP-HP) reported consulting experience breakthrough that has been in place since 2003 within its facility with two GPs which provide 30-35 consultations per month for a half-day per week.

These GPs "specialized" in hepatitis C patients receiving tested positive for HCV but without balance, which were sent to them in half of the cases by the attending physician in a third of cases by health centers for drug users. In 10% of cases, patients were diagnosed long ago and did not care so far.

The "Advanced" consultation can shorten supported by a hepatologist, the time limit for such specialized consultation is two to three months, with the aim to respond quickly to questions asked patients about the disease and to complete the initial assessment.

It is "one of the answers to the question of training for general practitioners on hepatitis C," the doctors being contacted about their patients by GPs network, said Dr. Boyer.

The specialist said that it requires a lot of diplomacy on the part of network physicians to provide or correct the knowledge of physicians, the latter being also surprised that they send their patients to the hospital are supported by GPs.

Other difficulties are the risk of attachment of patient's physician network, the lack of decline in hepatologist vis-à-vis the patient during the first visit and the fact that the advanced consultation was "a victim of its success "with a longer time to go two or three weeks and the need to open a second time slot in the week, note Nathalie Boyer..