In Practice newsletter
5 February 2016
RACGP pre-budget submission demands lift on rebate freeze
The first In Practice of the year highlighted the importance of continued pressure on the Federal Government to lift the freeze on Medicare Benefits Schedule (MBS) rebates.
Reversing the MBS freeze is the top priority detailed in The Royal Australian College of General Practitioners (RACGP) 2016-17 pre-budget submission, made to the Federal Government today.
The current RACGP budget submission details four key strategies that will improve quality-led patient care, through increased investment in general practice.
The argument for lifting the MBS freeze is straightforward. Restricting rebates will increase out-of-pocket costs for patients, affecting their access to general practice services and thereby lead to increased expenditure in hospitals. The RACGP calls on the Federal Government to commit to ensuring that indexation of MBS rebates keeps pace with the costs of providing quality healthcare services in to the future.
Demand from medical students and post intern medical officers for Australian medical placements continues to grow, yet this demand has not been mirrored by an increase in hospital resourcing capacity. As a consequence, hospitals are facing overwhelming pressure to provide placements and training for junior doctors.
The establishment of learning hubs for general practice training to coordinate community training places, is the second recommended strategy in the RACGP pre-budget submission. The RACGP is calling for the creation of 200 FTE intern and PGY2&3 places within the community setting, increasing by 50 places per year to 400 FTE places by 2019-20. The learning hubs have the potential to align with Primary Health Networks (PHNs), leveraging from existing infrastructure to coordinate and support community placements across urban, regional and rural areas.
The RACGP’s Vision for general practice and a sustainable healthcare system is the basis of the third recommended strategy in the pre-budget submission: and proposes the development of a pilot for voluntary patient enrolment (VPE) to enhance chronic disease management within general practice.
Evidence shows the patient-centred medical home creates positive health outcomes, including but not limited to: less use of emergency departments, increased provision of preventive services and improved experiences for patients and practice staff. The proposed pilot study will provide the evidence required to prove that these benefits are real and can be achieved in the Australian context.
Prioritising general practice research through dedicated funding and support for research infrastructure is the fourth and final call in the RACGP pre-budget submission.
The RACGP recommendation includes the Federal Government committing $27 million over nine years to the establishment of a general practice research fellowship program, allocation of 10% of the National Health and Medical Research Council (NHMRC) project grants budget to general practice specific research, and investment of $2.5 million to establish an NHMRC Centre for Research Excellence in General Practice/Primary Care.
I encourage you to read the RACGP 2016-17 pre-budget submission and use these four key strategies in any forthcoming discussions with your local Federal Member.
Dr Frank R Jones
RACGP President
RACGP Expert Committee Education Pre-Fellowship (REC Education Pre-Fellowship)
The inaugural meeting of the REC Education Pre-Fellowship last month was an opportunity for committee members to identify key pre-fellowship priorities and issues for the RACGP going forward.
The immediate priorities for the REC Education Pre-Fellowship are to review pathways to Fellowship, including GP vocational training, specialist recognition (formerly called the Specialist Program Pathway), General Practice Experience pathway and Practice Based Assessment. This will include looking at how to ensure consistency and clarity in terms of what is expected per stage of training, and per Fellowship pathway.
Committee members also addressed key areas such as selection, progression through training, and remediation, using resources such as the RACGP Curriculum for General Practice, RACGP Standards for Vocational Training and the Competency Profile of a Newly Fellowed GP. The committee has begun what will be a very important focus of the RACGP, with an expectation that regular reports and updates will be made available concerning progression on these items.
REC Education Pre-Fellowship works in close collaboration with the REC Education Post-Fellowship, the Board of Censors and Board of Assessment, as well as RACGP Education Services.
Patients and GPs encouraged to talk about family history
A national study of 16,000 Australians has found 44% of Australians with a history of breast and/or ovarian cancer in their family have not spoken to their doctor about their family history.
This is despite up to one in five occurrences of ovarian cancer being an inherited form of the disease, often attributed to the BRCA1 and BRCA2 gene mutations that increase a woman’s risk of developing ovarian cancer.
To mark Ovarian Cancer Awareness Month, the RACGP has joined Ovarian Cancer Australia (OCA) in calling on Australian women to discuss known family history of breast and/or ovarian cancer with their GP, to ensure GPs are able to give an appropriate evaluation of their risk of inheriting ovarian cancer.
More information is available on the OCA website.
RACGP employment opportunity for GPs
The RACGP is currently seeking applications for the position of GP medical educator (AKT) for a fixed-term, part-time role located at the RACGP East Melbourne national office.
The role of the GP medical educator (AKT) is to develop and review RACGP assessments through quality assurance processes, blueprinting and effective content management. Liaising with Fellows nationwide, the GP medical educator also develops pre and post exam resources and provides training and presentations on core assessment activities.
Applications close Friday 12 February. For more information and key selection criteria please visit the RACGP website.
RACGP Clinical Pearl – Risks and complications of female genital cosmetic surgery
If your patient is considering female genital cosmetic surgery (FGCS), they should be warned that these are not approved medical procedures and the benefits are not proven. There are many potential risks and complications associated with FGCS such as wound dehiscence, infection, scarring, and dyspareunia. Furthermore, genital cutaneous sensitivity, erotic sensitivity and orgasmic capacity can be affected by FGCS and therefore have important implications for women’s quality of life.
For more information on the risks and complications of FGCS, visit Section 1.5 of RACGP Female Genital Cosmetic Surgery: a resource for GPs and other health professionals.
In Practice poll results – Defibrillators in the 5th edition of the RACGP Standards for general practices
Over the past three weeks the RACGP has conducted an In Practice survey seeking members’ views on defibrillators in the 5th edition of the RACGP Standards for general practices.
Nearly half of all respondents (49%) felt that defibrillators should be included as a mandatory Indicator that practices must meet for accreditation. A further 36% of respondents felt it should included as a non-mandatory Indicator and 14% of respondents felt that defibrillators should not be included in the 5th edition of the Standards at all.
Stakeholders will have further opportunity to comment on this and the Standards more broadly, when the first draft of the 5th edition Standards are released for public consultation on 15 February 2016. It is important to note that this first draft of the 5th edition Standards is a working draft. There will be further revisions to successive drafts of the Standards based on feedback received.
The RACGP thanks all poll respondents. The results and feedback will be used to ensure the RACGP is best placed to represent the views of the profession.