The release of the latest BEACH (Bettering the Evaluation and Care of Health) program data has added weight to the RACGP’s call to introduce a patient-centred ‘Medical Home’ for all Australians.
The RACGP’s view of the ‘Medical Home’ concept puts the general practitioner (GP) at the centre of coordinated, integrated and whole-person care delivery, and is driven by improved health outcomes, reduced hospital admissions and lower healthcare costs.
RACGP President Dr Liz Marles said there is a growing understanding of the benefits achieved when patient care is coordinated by an appropriately supported, GP-led, multidisciplinary team.
“GPs are managing 20.5 million more chronic conditions than they did 10 years ago. This statistic, coupled with an increase of pathology tests ordered (8 million) and an estimated 6.6 million more procedural treatments performed, has lent itself to a shift in service delivery models.
“GPs are now working more closely with practice nurses, aboriginal health workers and allied health professionals to share the workload, while still maintaining a central coordination role.”
While collaborative care arrangements were proving successful in reducing time spent by GPs managing activities such as check-ups, diabetes, atrial fibrillation and urinary tract infections, the data showed GPs were still feeling the pressure to squeeze more complex care into consultations, which averaged 15 minutes in length.
“GPs are working hard to provide high quality healthcare to their communities. However, where workforce shortages exist, GPs often have to provide more frequent, yet shorter consultations in order to meet patient demand,” Dr Marles said.
The College has long supported the use of longer consultations to aid quality care and continues to look for solutions to address related workforce shortages and other issues affecting the feasibility of undertaking level C and D consultations.
“There is a definite need for government review of inadequate MBS indexing, which currently fails to recognise the true costs of the provision of clinical services and running a practice,” Dr Marles said.
“It is often forgotten that GPs are running small businesses. Expenses such as rent, electricity, computers, staff costs and professional insurance must all be met, but this can only be achieved if adequate recognition and remuneration is available.”
Another of the BEACH data’s findings showed that of the participating GPs in 2011–12, over 50% had provided care in a residential aged care facility in the previous month.
“Provision of general practice services in aged care is a prime example of an area of practice where non-contact work, such as providing clinical advice to residential aged care facility nursing staff and writing scripts, is not financially supported despite often being complex and time consuming,” Dr Marles said.
Commenting on patient encounters, Dr Marles said she was surprised to find that at only 1.6 per cent of encounters the patient identified themselves as an Aboriginal and/or Torres Strait Islander person.
“Some GPs believe that they don’t have any Aboriginal and/or Torres Strait Islander people amongst their patient group, but they may be surprised. It is only when a general practice starts identifying the Indigenous status of all their patients that they can be sure and these patients, if eligible, can benefit from various measures in the Australian government’s Indigenous Chronic Disease package.”
An RACGP initiative that seeks to improve this percentage, is through the RACGP Standards for general practices (4th edition), which require general practices to demonstrate that they ‘routinely record Aboriginal and Torres Strait Islander status in their active patient health records.’
The RACGP congratulates Associate Professor Helena Britt and fellow research team on delivering such high quality and valuable research reports that will have numerous benefits for the general practice profession.