30 October 2009 Shifting perceptions endanger general practice
Australia has developed a primary health care system that has come to be regarded as a world leader. Our model, based on whole person, continuing, comprehensive and coordinated care, has produced international benchmark results in longevity, patient-doctor satisfaction, and preventable death rates. But this is in danger of being eroded by a shift in the perception of what GPs do.
During our most recent conference, GP’09, we were fortunate to have Professor Claire Jackson’s participation in the closing debate. Professor Jackson highlighted the attitudinal shift and its implications for the future structure of general practice. Professor Jackson talked in terms of ‘little sick’ versus ‘big sick’ – the notion that general practice deals with lots of minor ailments that can be treated quickly (and cheaply) by nurses, rather than by highly trained, overworked GPs.
If primary health care is approached in this way we could witness fragmented care, reduced patient safety and the deterioration of patient-doctor relationships. This is the danger of the legislation (the Midwives and Nurse Practitioners Bill, 2009) currently before parliament which will give midwives and nurse practitioners access to MBS/PBS from 1 November 2010.
While we strongly support strengthening the role of nurses in general practice, it must be in the context of collaborative general practice teams. An expanded role for nurse practitioners has the potential to enhance the range and quality of care provided to patients. Parallel silos of care will increase costs and worsen health outcomes.
In her recent Australian Doctor editorial, Professor Jackson points out that over the past 5 years collaborative general practice teams combining the skills of GPs, practice nurses, and allied health practitioners have proven the value of this team approach. Thanks Claire for a great presentation at GP’09 and a great follow up article.
To read Professor Jackson’s editorial in Australian Doctor, visit www.australiandoctor.com.au/ articles/8f/0c064c8f.asp. Professor Jackson’s GP’09 presentation can be found at www.racgp.org.au/ downloads/presentations/PrimaryCare.pdf.
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