GPs the key to improving chronic diseases
Statistics emerged this week showing that two in three Australians are on the road to developing heart disease, diabetes or chronic kidney disease.
According to the Australian Institute of Health and Welfare (AIHW), two in three Australian adults have at least three or more risk factors for these diseases, including smoking, consuming too much alcohol, not eating enough fruit and vegetables, being overweight or obese and having high blood pressure.
The report, Cardiovascular disease, diabetes and chronic kidney disease-Australian facts: Risk factors revealed a staggering 95% of adults did not eat the recommended amount of fruit and vegetables, almost two in three were overweight or obese and more than half did not do enough physical activity.
The results are unlikely to come as a surprise to GPs because we see far too many people present with multiple risk factors every day. Promoting change effectively is difficult because too often, unhealthy lifestyle choices have developed after many years of bad habits.
That’s why having a conversation rather than a consultation with patients is key. Seizing on cues from patients that they want to change is also important. As GPs we are in the privileged position of having ongoing relationships with our patients and it’s this continuous model of care that makes us best placed to positively influence lifestyle choices. The impact of this influence is significant and can result in reducing a patient’s likelihood of developing many chronic diseases.
GPs looking for more information on working effectively with patients can also turn to the RACGP’s newly updated ‘SNAP guide’ – Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice. This resource aims to help GPs and their teams work with patients on the lifestyle risk factors of smoking, being overweight or obese, having a poor diet, not getting enough exercise and consuming too much alcohol.
Dr Frank R Jones
RACGP President
World Family Doctor Day 2015 – Why general practice?
World Family Doctor Day will be held on Tuesday May 19. To celebrate and share the incredible work of GPs, the RACGP has launched a social media campaign that asks GPs to state why they chose general practice as a career, using the dedicated hashtag #IchoseGP. The RACGP has developed posters for GPs to display in practice waiting rooms and graphics to share online, including Facebook and Twitter cover photos, all of which are available on the RACGP website.
There is also a poster for GPs to download that reads ‘#IchoseGP because … ’ . We want GPs to download and print the poster on World Family Doctor Day, write their reason for choosing general practice in the space provided, and post a photo of themselves holding the sign on social media with the hashtag #IchoseGP.
Tell the world why you chose general practice this World Family Doctor Day and together, we can raise the profile of the profession.
Australian general practice curriculum review
A dedicated group of medical writers and editors have been undertaking the triennial review of The RACGP Curriculum for Australian General Practice 2011. The aims of the review are to complete the conversion of the curriculum to a competency-based framework, reduce duplication and increase relevance to all stakeholders.
Approximately 200 organisations and individuals have been identified to provide their views on the revised curriculum and the RACGP is now seeking stakeholder feedback. The review process and information on how to provide feedback can be found on the RACGP website.
RACGP feedback poll results – Chronic disease management same-day billing
Over the past three weeks, the RACGP’s In Practice poll asked readers whether patient care had been affected by changes prohibiting patients from claiming Medicare benefits for general consultation and chronic disease management (CDM) on the same day.
The results show that the new restrictions to same billing have significantly impacted patients and practice flow. Only 5% of poll respondents believe the changes to CDM billing have had little or no impact to their practice.
A minority of 15% of poll participants indicated that they ask patients to return for another consultation to follow up on health issues, while 38% of GPs chose to absorb the cost of unrelated consultation items when seeing a patient for a care plan review. Depending on patient circumstances and urgency, 40% of respondents did all of the above, and either relinquished payments, asked patients to return on another day, or requested that the patient pay the full fee for unrelated acute care.
Additional written feedback emphasised that the changes to same day billing hamper a culture of patient-centred and holistic care by preventing GPs from managing chronic diseases, addressing acute care issues and asking about other aspects of the patient’s health during the attendance. Consequently, individuals from low-socioeconomic backgrounds and those with complex multi morbidities, who usually face barriers of access, are at increased risk of poor health outcomes. This has resulted in greater difficulties in engaging hard-to-reach patients.
GPs also commented on the challenges they face when approached by patients for an issue that would constitute a separate consultation. They believe they would be breaching a duty of care by not addressing a clinical problem during a care plan consultation. Therefore, many GPs continued providing the services but chose to forgo a fee for the service or services. This will have a negative financial impact on the sustainability and viability of general practice.
The RACGP thanks all poll respondents for helping to better inform the direction of our advocacy work. The results and feedback will be used to ensure the RACGP is best placed to represent the view of our profession.