GP Specialisation Could Lead To Fragmentation

A review of general practice advertisements in the Brisbane and Sydney Yellow Pages by Professor David Wilkinson and colleagues in the current edition of the Medical Journal of Australia shows that about a quarter of these practices offer special services such as travel medicine, child and women's health, and skin checks.

Professor Wilkinson says at the far end of the scale, service fragmentation - where components of traditionally core general practice are separated into standalone services - could see the profession lose generalist skills and expertise.

He also says if more doctors move into fragmented services there may be fewer GPs to provide less attractive services such as nursing home visits, and fewer working in socially deprived areas.

Disadvantages to patients include lack of communication between practitioners, a reduced pool of expert GPs in the community and, if standards of quality care are not maintained, the possibility of sub-optimal care.

With this in mind, Professor Wilkinson says determining training and certification criteria and the accreditation of medical services are crucial. "Perhaps the RACGP and Australian Government together need to determine when a medical service provided by a GP is not really general practice and consider what additional or differential training and accreditation might be needed in these circumstances."

But Professor Wilkinson says the specialisation of GP services has its positives. These include providing alternate avenues for referral and access to specialist services, improved retention of GPs in the workforce, reduced GP burnout and improved business outcomes for such specialised practices.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT Professor David WILKINSON 07 3365 5450 / 0419 866 149

Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471