Welcome to The Lucky Country: the Royal Australian College of General Practitioners deters overseas-trained academic general practitioners

2020 ◽  
Vol 44 (5) ◽  
pp. 782
Author(s):  
Katharine A. Wallis
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Full Time ◽  
Teaching And Research ◽  
Minimum Requirement ◽  
Primary Health ◽  
Royal Australian College ◽  
Practice Activity

In assessing overseas-trained general practitioners (GPs) applying for specialist recognition in Australia, the Royal Australian College of General Practitioners (RACGP) sets a minimum requirement of 2 days per week ‘undertaking general practice activities’ over the 3 years prior to application. The RACGP does not consider academic practice (i.e. relevant teaching and research) to be a ‘general practice activity’, thereby blocking overseas-trained full-time academic GPs from specialist recognition in Australia. The actions of the RACGP have implications for access to quality primary health care in Australia.

scholarly journals Role Identification: an Impediment to Effective Core Primary Health Care Teamwork?

2021 ◽  
Author(s):  
◽  
Jean Ross
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Team Work ◽  
Role Clarity ◽  
Practice Nurses ◽  
Attitudinal Differences ◽  
Primary Health ◽  
The Future

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>

Costs and Remuneration for Cervical Screening in General Practice in the West of Scotland

1996 ◽  
Vol 1 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Susan Myles ◽  
Sally Wyke ◽  
Tracy Ibbotson ◽  
Sally Macintyre ◽  
Jim McEwen ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Cervical Screening ◽  
Sensitivity Analyses ◽  
The West ◽  
Skill Mix ◽  
Primary Health ◽  
Deprived Areas

Objectives: To investigate associations between costs and remuneration for cervical screening in general practice in relation to skill mix, features of practice structure and deprivation levels in the local area; and, to identify efficient policies for organising cervical screening in general practice. Method: Questionnaire survey and interview study in 87 general practices in Greater Glasgow Health Board an area in the west of Scotland which covers a socio-economically varied population. The main outcome measures were remuneration to cost ratios (RCRs) for cervical screening and their natural logarithms (logRCRs). Results: Both the costs of cervical screening and RCRs varied widely between the 87 practices taking part. RCRs ranged from 0.29 to 14.67 (mean 2.64, median 2.18, interquartile range 1.15–2.98). Twenty-one per cent (18) of practices earned less than they spent on the organisation of screening, whilst 9% (8) of practices had RCRs of more than 5:1. RCRs were significantly lower if medical staff were involved in either taking smears or dealing with results. RCRs did not vary by social deprivation score, despite uptake being lower in practices in more deprived areas. This was explained by nurses working in practices in deprived areas being more likely to take smears than nurses working in more affluent areas. Sensitivity analyses were undertaken, altering key time and cost assumptions. As a result, the absolute values of the RCRs changed, although the overall pattern of association did not, with the exception of doctor involvement in processing results which was no longer significant when average general practitioners’ income was substituted for locum rates. Conclusions: Practices in deprived areas may be responding to greater pressure of work by making optimal use of skill mix within the primary health care team. A more graduated incentive payment scheme may more fairly reward practices in deprived areas which are less likely to achieve 80% uptake due to relatively intractable features of practice structure. Assuming that practice nurses provide an equivalent quality of service to that provided by general practitioners, results suggest that doctor-nurse substitution would be cost-effective for general practice based cervical screening. Resource savings (principally doctor's time) could be redeployed to other areas of primary health care.

Chronic Condition Self-Management: A primary health care change management problem

2005 ◽  
Vol 11 (2) ◽  
pp. 70
Author(s):  
Susan Lambert
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Chronic Condition ◽  
Care Service ◽  
Health Care Service ◽  
Primary Health Care Service ◽  
Self Management ◽  
Primary Health

Australian general practitioners are recognising the need to implement some form of chronic condition management program to better service and cope with the ever-increasing number of patients presenting with chronic conditions. Chronic Condition Self-Management (CCSM) is one such program. In this paper it is argued that the basis of CCSM is a multi-disciplinary, care-team approach, and that implementation of such an approach represents a paradigm shift in primary health care service delivery. This equates to a significant innovation in primary health care service that, in economic terms, aims to increase primary health care outputs. Although general practitioners are at the centre of the change they cannot implement the change without the participation and collaboration of the other stakeholders. These stakeholders include other health service providers, the Divisions of General Practice, the Department of Health and Ageing, and the patient. This paper presents a general practice business model to illustrate the relationships between stakeholders in the primary health care sector and to identify the impact of CCSM on these relationships. The organisational and business issues that need to be addressed to promote the uptake of CCSM are also identified.

scholarly journals Role Identification: an Impediment to Effective Core Primary Health Care Teamwork?

2021 ◽  
Author(s):  
◽  
Jean Ross
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
General Practitioners ◽  
Team Work ◽  
Role Clarity ◽  
Practice Nurses ◽  
Attitudinal Differences ◽  
Primary Health ◽  
The Future

<p>This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores important aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. Role clarity and attitudinal differences are the topic of this thesis. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.</p>

scholarly journals Teamwork – general practitioners and practice nurses working together in New Zealand

2012 ◽  
Vol 4 (2) ◽  
pp. 150 ◽  
Author(s):  
Mary Finlayson ◽  
Antony Raymont
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
General Practitioners ◽  
Care Staff ◽  
Care Practice ◽  
Health Care Staff ◽  
Practice Nurses ◽  
Primary Health

INTRODUCTION: Teamwork in primary health care has been encouraged in New Zealand and in the international literature. It may improve work satisfaction for staff, and satisfaction and outcomes for patients. Teamwork may be classified as being multi-, inter- or transdisciplinary and is likely to be influenced by the nature of the work and the organisational context. AIM: To describe and analyse teamwork between general practitioners and practice nurses in New Zealand. METHODS: Data were drawn from a survey of general practices and from interviews with primary health care staff and management. RESULTS: Doctors and nurses in general practice in New Zealand see themselves as a team. Evidence suggests that the nature of the work and the business context most often leads to a multidisciplinary style of teamwork. Some providers have adopted a more intense teamwork approach, often when serving more disadvantaged populations or in caring for those with chronic illnesses. DISCUSSION: Concepts of teamwork differ. This article provides a classification of teams and suggests that most general practice teams are multidisciplinary. It is hoped that this will help personnel to communicate their expectations of a team and encourage progressive team development where it would be of value. KEYWORDS: Teamwork; primary care; practice nurses; general practitioners

Dilemmas at a Primary Health Care Center: a baseline study for Computer-Supported Cooperative Health Care Work

1992 ◽  
Vol 31 (03) ◽  
pp. 204-209 ◽  
Author(s):  
T. Timpka ◽  
J. M. Nyce
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Group Process ◽  
Critical Incident ◽  
Care Work ◽  
Work Activity ◽  
Health Care Center ◽  
Health Care Work ◽  
Primary Health

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.

Understanding the general practice nursing workforce in New Zealand: an overview of characteristics 2015–19

2021 ◽  
Vol 27 (1) ◽  
pp. 22
Author(s):  
Sarah L. Hewitt ◽  
Nicolette F. Sheridan ◽  
Karen Hoare ◽  
Jane E. Mills
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
Survey Data ◽  
Nursing Workforce ◽  
Roles And Responsibilities ◽  
Primary Health ◽  
Part Time ◽  
Role Confusion

Limited knowledge about the nursing workforce in New Zealand general practice inhibits the optimal use of nurses in this increasingly complex setting. Using workforce survey data published biennially by the Nursing Council of New Zealand, this study describes the characteristics of nurses in general practice and contrasts them with the greater nursing workforce, including consideration of changes in the profiles between 2015 and 2019. The findings suggest the general practice nursing workforce is older, less diverse, more predominately New Zealand trained and very much more likely to work part-time than other nurses. There is evidence that nurses in general practice are increasingly primary health care focused, as they take on expanded roles and responsibilities. However, ambiguity about terminology and the inability to track individuals in the data are limitations of this study. Therefore, it was not possible to identify and describe cohorts of nurses in general practice by important characteristics, such as prescribing authority, regionality and rurality. A greater national focus on defining and tracking this pivotal workforce is called for to overcome role confusion and better facilitate the use of nursing scopes of practice.

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