General practitioners (GPs) see patients from all walks of life, with a broad spectrum of presentations. The scope of general practice that each individual doctor practises within also varies significantly. GPs are well trained in being able to manage a range of individual patient needs; however, the quality of care provided depends on the organisation of care. GPs work in a complex system of regulatory bodies and organisations, and therefore need to understand the key principles of the practice environment and its processes, management and accreditation to ensure quality care. This includes at the practice, local, state and federal levels.
A core responsibility of GPs is to prescribe within the Pharmaceutical Benefits Scheme (PBS) rules and bill Medicare appropriately. In addition to prescribing within the scope of evidence-based medicine, a GP needs to adhere to the PBS regulations and Department of Veterans’ Affairs (DVA) regulations, and prescribe scheduled medicines, including S8 and S4 drugs safely, appropriately and in accordance with their jurisdiction’s regulations.1,2 In terms of using Medicare for their services, from consultations for medical issues to care plans and various procedures, a GP needs to ensure that their record keeping and the service provided within the consultation adhere to the descriptors of the item under the Medicare Benefits Schedule.3 There are also rules for private billing; for example, around workers’ compensation consultations and wound management, that a GP needs to be aware of and compliant with.
Another important aspect of practising as a GP is being aware of medico-legal responsibilities and avenues for support. Medical indemnity is an essential component of being a registered medical practitioner in Australia; however, it is also an important resource for advice and personal protection.4 GPs also need to understand their regulatory responsibilities regarding providing certificates, including for Centrelink, workers’ compensation and sickness, as well as the requirements for mandatory reporting, such as in cases of suspected child abuse.5
There are many resources and supports available for vulnerable groups, including for Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, and refugees. GPs and practice staff need to understand the best methods for identifying these patients in a culturally safe manner.6 GPs also need to be aware of, and advocate for, programs such as the Closing the Gap initiative,7 and other resources and programs that could be beneficial to patient cohorts. GPs in rural and remote areas need to understand how to manage their time and priorities in their communities, as populations in these areas experiences significant disparities in terms of health access and promotion.
All patients have the right to confidentiality and informed consent. This is particularly important for vulnerable populations. GPs are required to understand these issues and act within legal and ethical boundaries.8 Appropriate record keeping and an effective recall system are essential tools in a practice’s framework that can help protect the rights and safety of both the patient and practitioner.9 Awareness and understanding of how to navigate the differences in state and federal laws for issues, such as voluntary assisted dying, regulations for telehealth and mandatory reporting responsibilities, are also essential. GPs also need to develop a good working relationship with their colleagues who can often offer guidance through their own lived experience as a practitioner navigating these complex organisational and legal dimensions.