26 August 2016


The resilient GP

Resilience is the positive adjustment to adversity.

Are you still inspired by quality patient care? Do you still have that clinical curiosity? Or do you just turn up for work and do the bare necessities only?

How does an altruistic, skilled and passionate young GP become disillusioned? And importantly, can this affect patient care?

These are some difficult questions, and many of us barely have time to reflect on them amongst the hurly-burly of front-line general practice.

Last week I had the privilege of addressing a group of GPs and academic colleagues about this particular issue, which is contentious and challenging to debate.

Although there is limited research in this area, we do know that up to one third of GPs are periodically emotionally exhausted, have difficulty showing empathy and under-value their achievements.

System issues, patient issues and individual character traits are all contributing factors to GP disillusionment.

There is recognition of the changing role of the doctor in our society. Medical schools now openly discuss the ‘hidden curriculum’, which includes personal and professional development.

The RACGP curriculum for general practice talks about ‘the capacity for self-awareness, reflection and self-appraisal’. Will this make future GPs more resilient? (Anecdotally, Generation Y seem more measured in assessing work-life balance.) 

What about when someone is established as a full time GP? There is no formal ‘career pathway’, and our work is challenging and sometimes exhausting, especially with the change in health demography and demand. Our consultations are increasingly volume-intense, we are time-poor and our critical skills seemingly undervalued.

The RACGP campaign, ‘The Good GP‘, is a stepping-stone towards educating our patients and communities about our skills profile, and also improving GP self-esteem.

I have often used the term ‘the GP trajectory’ to describe a potential pathway which translates to being flexible and open to the acquisition of new skills and directions. I believe this is the key to GP professional resilience, as it keeps you engaged and active!

The reason for discussing this in In Practice? The RACGP is a fantastic institution which provides an endless scope of activities for personal and professional development. I feel my personal involvement with the RACGP over the years - in education, research, advocacy, specific interests and with all the other connections it provides - has improved my sense of self-fulfilment and provided a sense of collegiality.

I would humbly suggest that the RACGP can help nourish GP resilience, which in turn will help maintain our enthusiasm and improve the care we provide for our patients and communities.

Dr Frank R Jones
RACGP President


Your views sought on referring to other medical specialists

The RACGP is seeking member feedback on the outcomes of your referrals to other medical specialists. Some of the issues identified in recent commentary and currently being considered by the RACGP include other medical specialists:

  • asking for a new referral every 12 months for a patient with the same ongoing problem
  • not acknowledging or responding to referrals from GPs
  • not accepting indefinite or timed referrals from GPs for periods other than 12 months
  • communicating inconsistently with the referring GP about referrals to other specialists.

The RACGP is seeking member feedback on these and any additional issues relating to how your referrals have been handled by other medical specialists. Your feedback will inform our advocacy on behalf of GPs and RACGP members are invited to provide feedback via the RACGP website.

GP16 Perth extravaganza only a month away

GP16 is the highlight event of the year in the general practice calendar, so register now to make sure you are involved.

Some active learning modules (ALMs) and cardiopulmonary resuscitation (CPR) workshops still have places available to assist you in fulfilling your quality improvement and continuing professional development (QI&CPD) requirements for the year.

  • 25% of ALM places are still available
  • 130 CPR workshop places are filled
  • 240 gala dinner tickets have been sold
  • 117 organisations will be represented in the exhibition hall.

Register now to secure your place at this year’s conference.


Practice Based Assessment Pathway – applications now open

The Practice Based Assessment Pathway pilot program will begin in 2017. Applications are now open and close on Friday 30 September 2016.

The new pathway replaces the former Practice Based Assessment (PBA) and has been developed in response to a comprehensive review and consultation process.

Interested candidates can begin the application process by accessing the eligibility self-assessment tool on the RACGP website.


Clinical pearl

A basic dementia screen in general practice

Dementia is diagnosed on the basis of clinical criteria following a comprehensive clinical assessment, including: history; cognitive and mental state assessment; physical examination; and medication review. The following blood tests should be included at the time of assessment: routine haematology; biochemistry tests including electrolytes, calcium, glucose, and renal and liver function; thyroid function tests; serum vitamin B12; and folate levels.

The dementia screen may help identify an alternative reason for presenting symptoms. People with a possible diagnosis of dementia should be offered referral to memory assessment specialists or services for a comprehensive assessment. As specialist assessment services are not always available in rural and remote areas, the Clinical practice guidelines and principles of care for people with dementia state that strategies to ensure access should be implemented.

Visit the National Clinical Practice Guidelines for Dementia in Australia for more information. These clinical practice guidelines were recently endorsed by the RACGP.


In Practice poll question – Standards patient feedback

What method of collecting patient feedback best suits your practice?

Vote Option

Percentage

Patient questionnaire (paper or online)

74

Patient interviews (face to face or via telephone)

2

Patient focus groups, hosted by your practice

3

Electronic tools (eg SMS, survey tools, tablets)

19

Other – please specify (email standards@racgp.org.au)

2


The RACGP is currently consulting stakeholders on the 5th edition of the Standards for general practices (the Standards).

Collecting and responding to patient feedback has been shown to improve clinical effectiveness, patient safety, adherence to recommended medication and treatments, and preventive care. To assist with the continued refinement of patient feedback indicators in the 5th edition Standards and the accompanying patient feedback guide, the RACGP has polled members on what methods best suit their practice for collecting patient feedback.

Poll results indicate respondents’ greatest preference for collecting patient feedback in their practice is by using patient questionnaires (74%), either in paper or online format. A further 19% of responses indicated a preference for electronic methods such as SMS and survey tools for this purpose.

Patient focus groups (3%) and patient interviews (2%) were the least preferred methods for seeking patient feedback.

The RACGP thanks all poll respondents for their feedback, which will be used to inform decisions around patient feedback indicators in the 5th edition Standards. The RACGP’s consultation on the 5th edition of the Standards will continue until 30 September 2016. To access the current draft and further information, visit the Standards development page.


Media enquiries

Journalists and media outlets seeking comment and information from the RACGP should contact:

John Ronan

Senior Media Advisor