Family Doctor Week review
The AMA advocated strenuously for general practice and primary health care during Family Doctor Week, July 21 to 27. AMA President Dr Tony Bartone made numerous public appearances and policy announcements during the week to highlight the AMA’s ongoing campaign of support for the vital role of general practitioners. While the President’s National Press Club address and his media conference with Health Minister Greg Hunt (both reported elsewhere in this edition of Australian Medicine) drew serious media attention during the week, so too did other advocacy statements made as part of Family Doctor Week. Below is a snapshot of some of the AMA’s Family Doctor Week 2019 activities.
The need to ensure a future workforce
The AMA warned that Australian communities will miss out on the vital health care provided by high-quality family doctors unless there is urgent action to encourage medical students and young doctors to choose general practice as their medical specialty.
Dr Bartone, a Melbourne GP for more than 30 years, said it is a tragedy that GP training places are going unfilled.
“Since 2015, we have seen a 20 per cent fall in the number of applications for GP training, and a six per cent drop in the number of first year GP training posts filled,” Dr Bartone said.
“In 2019, 63 first year GP training places went unfilled even though multiple recruitment rounds were initiated.
“This is despite Australia now graduating around 3700 medical students each year. This is an incredibly ominous sign for the future of the general practice workforce.
“It is vital that general practice is seen as a desirable career choice.
“The AMA is working hard to ensure that those doctors who want to specialise in general practice are not discouraged from doing so.
“We need to offer medical graduates who want to pursue a career in general practice positive training experiences that highlight the diversity of work and whole-of-patient care it offers, so that they have a proper understanding and appreciation of general practice, how it functions, and the role it plays in the health system.
“We also need to make sure our GPs and GP registrars work and train in supportive and rewarding environments.”
GPs can help with mental health care
Australians are increasingly going to see their family doctor about their mental health care, with GPs the first destination for families and individuals in need of care.
“Mental health issues being experienced by one member of a family can affect others, as well as colleagues and friends,” Dr Bartone.
“Australia’s mental health system allows family doctors to provide the necessary direct help or collaborative referral. Mental health problems are common. About one in five of us will experience a mental health problem at some point in our lives.
“Talking with your GP about your mental health and wellbeing is so important. Doctors’ visits are confidential, and your family doctor is appropriately trained about the management of mental health.
“GPs can diagnose medically definable mental health disorders, order tests to eliminate physical causes of symptoms, prescribe medications, and provide coordinated care, including collaborative referrals to psychiatrists, psychologists, and social workers.
“GPs can also help patients with personalised GP Mental Health Care Plans, providing a structured management approach to their care. This personalised managed approach is particularly valuable in a fragmented and poorly resourced overall health system, with access difficulties essentially enshrined.
“The AMA supports measures that reinforce the central role of GPs in mental health care. Investments in primary mental health care will improve the ability of GPs to undertake assessments and make sure their patients see the most appropriate specialised service to best meet their needs.”
National preventive health strategy
The Australian Government must commit adequate resources to its proposed long-term national preventive health strategy, and work with GPs to help improve the health of all Australians.
Dr Bartone said the AMA is looking forward to working on the strategy, which Health Minister Greg Hunt first announced in a video message to the AMA National Conference in May.
“Preventive health measures reduce the rate of chronic ill health and improve the health and wellbeing of all Australians, leading to better and healthier lives,” Dr Bartone said.
“As a nation, we spend woefully too little on preventive health – around two per cent of the overall health budget.
“A properly resourced preventive health strategy, including national public education campaigns on issues such as smoking and obesity, is vital to helping Australians improve their lifestyles and quality of life.
“Family doctors – GPs – are best placed to manage preventive health, and can assist their patients in managing issues such as weight, alcohol consumption, physical activity, stress, substance use, and quitting smoking…
“If you want to quit smoking, start by seeing your family doctor.”
Catch-up vaccinations for adults
The AMA is advocating that all Australian adults should be eligible for free catch-up vaccinations, under the National Immunisation Program (NIP), to protect as many people as possible from preventable diseases.
“Immunisation is the most important way that Australians can protect themselves, their family and friends, and others in the community from illness and death,” Dr Bartone said.
“GPs, our family doctors, are well-placed to advise on and provide vaccinations to adults and children alike, and currently deliver about three-quarters of all vaccinations to children under the age of six years.
“Australia has one of the most comprehensive, publicly-funded immunisation programs in the world and we are very close to reaching the target of 95 per cent immunisation coverage for one- and five-year-olds.
“However, it is estimated that there are about 4.1 million under-vaccinated Australians each year, and most of them are adults.
“There are many reasons why adults might be unvaccinated or under-vaccinated. Vaccinations may not have been available at the time, people may have migrated to Australia from countries without a strong vaccination regime, or there may be no record of their vaccination.
“The Federal Government currently funds catch-up vaccinations through the NIP for people under the age of 20 years who may have missed out on their childhood vaccinations, and for refugees and humanitarian entrants of any age.
“Other adults have to pay, which can add up to hundreds of dollars, depending on the number of vaccinations that need to be caught up on.
“The AMA is calling on the Government to fund all catch-up vaccinations, recognising that immunisation is a cost-effective public health measure.
“Vaccination status should not be determined by wealth. All people wishing to be fully vaccinated should have access to Government-funded recommended vaccines.
“This will help enhance herd immunity within the community and will help avoid outbreaks of preventable and potentially deadly diseases.”
A recent major report from the Australian Institute of Health and Welfare (AIHW) has confirmed that GPs are doing an outstanding job looking after their patients’ health, and that patients with a regular GP enjoy a smoother journey through the health system.
Released in July, the report – Coordination of health care: experiences of information sharing between providers for patients aged 45 and over – provides further evidence of the importance of developing a relationship with a usual GP.
Dr Tony Bartone said the report, which uses data from the 2016 Survey of Health Care, reinforces the theme of AMA Family Doctor Week 2019 – Your Family Doctor and You: Partnering for Health.
He said 96 per cent of surveyed patients with a usual GP reported that their health care needs were known by their GP and that their test, X-ray, or scan results were always available.
“The report stresses the vital role of family doctors in helping their patients navigate the health system,” Dr Bartone said.
“When patients have to go to other specialists, the emergency department at the hospital, or to allied health care providers, the GP ensures that patient information is shared and records are kept.
“The report shows that patients with a usual GP are three times more likely to have the information from their most recent specialist visit and twice as likely to have their information following a visit to the emergency department than patients without a usual GP.
“This backs Productivity Commission data from earlier this year that found that 91.8 per cent of patients said their GP always or often listened to them, 94.1 per cent said that the GP always or often showed them respect, and 90.7 per cent said the GP always spent enough time with them.
“Clearly, Australia’s GPs are doing a fantastic job.”
Aged care resources
A lack of resources and funding is hampering family doctors who want to continue providing care to older patients who move into residential aged care, Dr Tony Bartone said.
Dr Bartone stressed that GPs provide cradle-to-grave care for patients.
“In Family Doctor Week, it is important to pay tribute to GPs who have cared for patients throughout all stages of their lives, but now face hurdles when wanting to care for these same patients when they enter aged care facilities,” Dr Bartone said.
“For older people, continuity of care is important, as patients benefit the most from a lifelong relationship with a GP.
“Doctors who visit aged care facilities usually have a long-standing association with their patients, and want to continue their clinical care.
“However, AMA members tell us that they are continually meeting barriers to facilitating that care, despite the improved health outcomes from a long-standing doctor-patient relationship.
“The Royal Commission into Aged Care Quality and Safety is highlighting the evident lack of support from both the health and aged care systems for doctors caring for patients in aged care...
“The AMA is calling for an appropriate and mandated staff-resident ratio that aligns with the level of care needed in each facility, and ensures 24-hour on-site registered nurse availability.
“The AMA is also calling for Medicare rebates to increase by at least 50 per cent to adequately compensate family doctors for the additional time and complexity involved in a visit, compared to a consultation in the GP’s practice.
“The injection of almost $100 million in the last term of government was a welcome start, but more will be needed.”
Published: 02 Aug 2019