Quality selection, training vital to safeguarding GP future
By Dr Penelope Need, Director of General Practice training at Southern Adelaide Local Health Network; tutor in Medical Professional and Personal Development, University of Adelaide; Partner, Pioneer Medical Centre, Tea Tree Gully, South Australia.
General practice training is having its first shake up since the implementation of the training providers more than 10 years ago.
The last couple of years have seen large numbers of applicants. General practice is a specialty of choice for many junior doctors. We need to keep it that way.
Quality general practice training is mandatory if we wish to maintain high standards in primary care.
General practice is a challenging career. Future GPs need to be carefully selected and trained to a high standard.
We all know that primary care is the most cost effective area of the health system. Why then is it being targeted for so much reform?
I have a tutorial group of nine year 3 medical students, none of whom have a GP. If these carefully selected medical students don’t see the value in general practice then how can the rest of the community?
At interviews, potential GP registrars can tout “continuity of care”, but is this still a reality?
Access is a real issue in general practice at the moment. Chronic disease management, and an aging and increasingly overweight and mentally distressed population puts a strain on well-meaning general practitioners.
The current model of funding rewards throughput. Is this what we want to see into the future? Are we going to be palliating our own patients or leaving it to the ambulance officers?
Pharmacists are providing vaccinations, physiotherapists are requesting referral rights. Why? How has this gap been created that someone wants to fill?
That other catch cry of general practice, “holistic care”, is also under threat.
The solution to these problems starts with selection. We need to select appropriate individuals. Selecting rural students has been shown to increase rural retention.
We then need to ensure they are adequately trained.
The loss of the Prevocational General Practice Placements Program is a real blow for general practice. It was vital for improving inter-professional communication and respect. Emergency, medicine and surgery are all mandated in internship. Why not primary care? Like anything, until you are exposed to general practice you do not understand the complexity and the challenges.
The AMA is looking at alternative models of reviving prevocational exposure to general practice. I personally feel this is vital for the ongoing health of the profession.
Just because we have a lot of applicants for general practice training does not mean that we will have a lot of quality GPs in another three years. We need to select the right people for the job and train them to a high standard.
Maybe a litmus test – would you be happy to be treated by doctors trained under this program? Don’t be like my third year medical students – everyone needs a good GP. Let’s just hope there will be enough to go around.