scholarly journals General practice registrars' views on maternity care in general practice in New Zealand

2015 ◽  
Vol 7 (4) ◽  
pp. 316 ◽  
Author(s):  
Hanna Preston ◽  
Chrystal Jaye ◽  
Dawn Miller
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Maternity Care ◽  
Shared Care ◽  
Online Questionnaire ◽  
Maternity Services ◽  
Training Support ◽  
Learning Platform ◽  
Practice Education

INTRODUCTION: The number of general practitioners (GPs) providing maternity care in New Zealand has declined dramatically since legislative changes of the 1990s. The Ministry of Health wants GPs to provide maternity care again. AIM: To investigate New Zealand general practice registrars' perspectives on GPs' role in maternity care; specifically, whether maternity services should be provided by GPs, registrars' preparedness to provide such services, and training opportunities available or required to achieve this. METHODS: An anonymous online questionnaire was distributed to all registrars enrolled in The Royal New Zealand College of General Practitioners' (RNZCGP's) General Practice Education Programme (GPEP) in 2012, via their online learning platform OWL. RESULTS: 165 of the 643 general practice registrars responded (25.7% response rate). Most (95%) believe that GPs interested and trained in maternity care should consider providing antenatal, postnatal or shared care with midwives, and 95% believe women should be able to access maternity care from their general practice. When practising as a GP, 90% would consider providing antenatal and postnatal care, 47.3% shared care, and 4.3% full pregnancy care. Professional factors including training and adequate funding were most important when considering providing maternity care as a GP. DISCUSSION: Ninety-five percent of general practice registrars who responded to our survey believe that GPs should provide some maternity services, and about 90% would consider providing maternity care in their future practice. Addressing professional issues of training, support and funding are essential if more GPs are to participate in maternity care in New Zealand. KEYWORDS: General practice; education; maternity care; New Zealand; rural health services

scholarly journals Repeat prescribing policy in New Zealand general practice: making it better

2020 ◽  
Vol 12 (4) ◽  
pp. 373
Author(s):  
Steven Lillis ◽  
Liza Lack
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Local Development ◽  
Policy Research ◽  
Practice Research ◽  
Annual Conference ◽  
Protected Time ◽  
Repeat Prescribing ◽  
General Practices

ABSTRACT INTRODUCTIONRepeat prescribing is common in New Zealand general practice. Research also suggests that repeat prescribing is a process prone to error. All New Zealand general practices have to comply with requirements to have a repeat prescribing policy, with the details of the policy to be designed by the practice. AIMTo inform the development of practice policy, research was undertaken with experienced general practitioners to identify and mitigate risk in the process. METHODSAt the 2019 annual conference of the Royal New Zealand College of General Practitioners, a workshop was held with 58 experienced general practitioner participants. The group was divided into six small groups, each with the task of discussing one aspect of the repeat prescribing process. The results were then discussed with the whole group and key discussion points were transcribed and analysed. RESULTSIssues identified included: improving patient education on appropriateness of repeat prescribing; having protected time for medicine reconciliation and the task of repeat prescribing; reducing the number of personnel and steps in the process; and clarity over responsibility for repeat prescribing. DISCUSSIONThis research can inform the local development of a repeat prescribing policy at the practice level or be used to critique existing practice policies. Attention was also drawn to the increasing administrative burden that repeat prescribing contributes to in general practice.

Realising the health benefits of safe work - a continuing professional education for primary care practitioners

2014 ◽  
Vol 9 ◽  
Author(s):  
Kevin Sleigh
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Professional Education ◽  
Health Benefits ◽  
Continuing Professional Development ◽  
Local Staff ◽  
Safe Work ◽  
Education And Awareness ◽  
Awareness Raising ◽  
Practice Education

Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program.Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals.Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff.Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients.Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.

scholarly journals Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners

2015 ◽  
Vol 7 (3) ◽  
pp. 244 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Dug Yeo Han ◽  
Anne-Thea McGill ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Medical Students ◽  
General Practitioners ◽  
Health Knowledge ◽  
Nutrition Therapy ◽  
Routine Care ◽  
Nutrition Care ◽  
Positive Attitudes ◽  
Health Knowledge Attitudes Practice

INTRODUCTION: Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. AIM: This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. METHODS: A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. RESULTS: All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (p<0.0001) and performing nutrition recommendations (p<0.0001). General practice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (p<0.0001); macronutrients (p=0.030); micronutrients (p=0.010); and women, infants and children (p<0.0001). DISCUSSION: New Zealand medical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted. KEYWORDS: General practitioner; health knowledge, attitudes, practice; medical education; nutrition therapy

scholarly journals General Practitioners providing obstetric care in New Zealand. What differentiates GPs who continue to deliver babies?

2017 ◽  
Vol 9 (1) ◽  
pp. 9 ◽  
Author(s):  
Zara Mason ◽  
Chrys Jaye ◽  
Dawn Miller
Keyword(s):  
New Zealand ◽  
Maternity Care ◽  
Obstetric Care ◽  
Shared Care ◽  
Structured Interviews ◽  
Birth Process ◽  
Professional Isolation ◽  
Local Solutions ◽  
Legislative Changes ◽  
Maternity Practice

ABSTRACT AIM To identify factors that have enabled some New Zealand general practitioner obstetricians (GPOs) to continue providing maternity care and factors implicated in decisions to withdraw from maternity care. METHOD Semi-structured interviews and one focus group (n = 3) were conducted with 23 current and former GPOs. Interviews were transcribed and analysed thematically. RESULTS Current and former GPOs practiced maternity care because they enjoyed being involved in the birth process and delivery suite environment. Their maternity practice was framed by a philosophy of lifelong continuity of care for patients. Legislative changes in New Zealand and barriers to shared care that resulted in many GPOs withdrawing from maternity care left remaining GPOs feeling professionally isolated; another reason for ceasing maternity care. Funding was perceived to be inadequate and on-call demands were both major disincentives to providing maternity and intrapartum care. Current GPOs often have strong supportive local relationships with other maternity providers when compared with those no longer practicing. Local shared care arrangements enhance professional support and reduce professional isolation. CONCLUSION GPOs still practicing in New Zealand do so because they find maternity care highly rewarding despite their perceptions that the current maternity care model is incompatible with general practice. They have often developed local solutions that support their practice, particularly around shared care arrangements.

scholarly journals Pharmacist integration into general practice in New Zealand

2019 ◽  
Vol 11 (2) ◽  
pp. 159 ◽  
Author(s):  
Robert Haua ◽  
Jeff Harrison ◽  
Trudi Aspden
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Online Questionnaire ◽  
District Health ◽  
Long Term Conditions ◽  
The North ◽  
Medicines Reconciliation ◽  
Medication Reviews ◽  
General Practices

ABSTRACT IntroductionPharmacist integration into general practice is gaining momentum internationally, with benefits noted in reducing medication errors, improving chronic disease management and alleviating general practitioner workforce shortages. Little is known about how general practice pharmacists are working in New Zealand. AimThis study characterised the current landscape of pharmacist integration into general practice in New Zealand. MethodsAn online questionnaire was developed, piloted and distributed to all pharmacists in New Zealand. ResultsThirty-six responses were analysed. Respondents were more likely to be female, have been pharmacists for at least 10 years and all but one held formal postgraduate clinical pharmacy qualifications. Seven pharmacists were working as pharmacist prescribers. Primary health organisations (PHOs) were the most common employer, with funding primarily derived from either PHOs or District Health Boards. Pharmacist integration into general practice appears to have progressed further in particular regions of New Zealand, with most respondents located in the North Island. Tasks performed by respondents included medication reviews, managing long-term conditions and medicines reconciliation. Increased job satisfaction compared with previous roles was reported by most respondents. Funding and a general lack of awareness about pharmacists’ professional scope were seen as barriers to further expansion of the role. DiscussionThis study describes the characteristics of pharmacists currently working in general practices in New Zealand and provides insights into key requirements for the role. Understanding the way practice pharmacists are currently employed and funded can inform general practices considering employing pharmacists.

scholarly journals The rural medical generalist workforce: The Royal New Zealand College of General Practitioners’ 2014 workforce survey results

2016 ◽  
Vol 8 (3) ◽  
pp. 196 ◽  
Author(s):  
Deanne L. Wong ◽  
Garry Nixon
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Response Rate ◽  
Hospital Medicine ◽  
International Medical Graduates ◽  
Medical Graduates ◽  
Rural And Urban ◽  
Survey Results ◽  
Zealand College

ABSTRACT INTRODUCTION Previous surveys have revealed a New Zealand rural medical generalist workforce that is mainly male, older and dependent on international medical graduates (IMGs). AIMS To provide a snapshot of the New Zealand rural medical generalist workforce in 2014 and to make comparisons with the urban medical generalist workforce. To assess future workforce losses and find ways to address them. METHODS In March/April 2014, a survey of members of The Royal New Zealand College of General Practitioners used the SurveyMonkey tool. A comparative analysis was undertaken ofself-identified rural and urban respondents. RESULTS The response rate was 55.9% (2525/4514). Of the 2203 working respondents, 17.1% self-identified as rural, working in rural general practice or rural hospital medicine. Compared with urban respondents, more rural generalists were male (57.5% rural vs 45.5% urban; P < 0.01), aged ≥ 55 years (38.2% rural vs 32.6% urban; P = 0.04) and involved in teaching (53.0% rural vs 30.0% urban; P < 0.01). IMGs were an integral part of the rural generalist workforce (52.8% rural vs 38.7% urban; P < 0.01). More rural generalists worked ≥ 36 h per week (66.8% rural vs 50.4% urban; P < 0.01) and they were more likely to retire within the next 10 years (40.4% rural vs 34.7% urban; P = 0.0417). DISCUSSION The rural medical generalist workforce continues to be mainly male, older and consist of a high proportion of IMGs. Findings confirm the fragility of this workforce and highlight the need for renewed efforts to improve recruitment and retention.

scholarly journals Repeat prescribing safety survey

2019 ◽  
Vol 11 (3) ◽  
pp. 243
Author(s):  
Steven Lillis ◽  
Nicki Macklin ◽  
Michael Thorn ◽  
Emma Wicks ◽  
Kristin Good ◽  
...  
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Safety Profile ◽  
Response Rate ◽  
Developed Countries ◽  
Expert Group ◽  
Repeat Prescribing ◽  
Accepted Part ◽  
Zealand College

ABSTRACT INTRODUCTIONRepeat prescribing is an accepted part of general practice activities in New Zealand and in many developed countries. However, there has been little research on how this service is used in New Zealand, or on clinicians’ attitudes towards it. AIMTo discover the opinions of vocationally registered general practitioners (GPs) and general practice registrars regarding repeat prescribing, availability of practice policy and mechanisms for issuing such prescriptions. METHODSA survey was developed by an expert group and shared through the Royal New Zealand College of General Practitioners’ (the College) weekly newsletter, epulse, inviting members to participate in the survey. The survey was also emailed to registrars. RESULTSIn total, 144 vocationally registered GPs and 115 registrars responded (n=259), giving a response rate of 3.2% for GPs and 12.7% for registrars. Patient convenience and time efficiency for the practice were the most commonly cited reasons for repeat prescribing. Registrars had low awareness of practice policy on repeat prescribing and only one-quarter of practices had an orientation pack that contained advice on repeat prescribing. DISCUSSIONBetter practice systems are likely to improve the safety profile of repeat prescribing and should be addressed. There is substantial unwanted variability currently in these practice systems.

scholarly journals Rural women’s perspectives of maternity services in the Midland Region of New Zealand

2016 ◽  
Vol 8 (3) ◽  
pp. 220 ◽  
Author(s):  
Veronique Gibbons ◽  
Gytha Lancaster ◽  
Kim Gosman ◽  
Ross Lawrenson
Keyword(s):  
Quality Of Care ◽  
New Zealand ◽  
Rural Women ◽  
Maternity Care ◽  
Care Provision ◽  
Access To Services ◽  
Maternity Services ◽  
Rural Maternity Care

ABSTRACT INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women’s perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

scholarly journals The Anorexia Nervosa Genetics Initiative: Study description and sample characteristics of the Australian and New Zealand arm

2017 ◽  
Vol 51 (6) ◽  
pp. 583-594 ◽  
Author(s):  
Katherine M Kirk ◽  
Felicity C Martin ◽  
Amy Mao ◽  
Richard Parker ◽  
Sarah Maguire ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
New Zealand ◽  
Medical Care ◽  
General Practitioners ◽  
Body Mass ◽  
Community Sample ◽  
Online Questionnaire ◽  
Current Body Mass Index

Objectives: Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand. Methods: Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis. Results: Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m2. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m2 were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m2 (23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%). Conclusions: This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa.

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