GPs under pressure caring for people with chronic diseases

Chronic diseases such as diabetes, cardiovascular disease and depression are placing an increasing burden on Australia's healthcare system, especially in general practice.

Although the federal government provides incentive payments to GPs to improve chronic-disease care, the complexity of the incentives, and the bureaucratic procedures involved, mean that many GPs are not making full use of the incentives.

In a study involving 54 GPs from urban and rural practices, researchers from the University of New South Wales and the University of Adelaide explored GPs' perceptions of chronic-disease care, their views on government incentives, and their suggestions for improving the standard of care.

The study, reported in the latest issue of the Medical Journal of Australia, shows that GPs experience conflicting pressures and increasing demands — from patients and from the Department of Health and Ageing — as they attempt to provide better care for patients with chronic disease.

Structured multidisciplinary care is needed for patients with chronic illnesses. Barriers to providing this mode of care include the lack of fit between systems oriented towards acute care and the demands of chronic-disease care; bureaucratic, inflexible structures; and the complex nature of GP-patient relationships.

Policy and attitude changes are required to enable GPs to move from episodic care to providing long-term care as part of a multidisciplinary team.

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

CONTACT:  Professor Mark Harris, University of NSW, 0418 223 470

Mr Gawain Powell Davies, University of NSW, 02 9425 237 141, 02 9385 1506 (work),

Judith Tokley AMA 0408 824 306