Transcript: AMA President Dr Steve Hambleton, AM, ABC Radio

Subject:          GP best practice study findings

TONY EASTLEY: Dr Hambleton, thanks for joining us on AM. Are you surprised by the figures in this study?

STEVE HAMBLETON: Well I guess I'm not surprised by the figures. But it's - we're measuring a process here, I suppose, and not measuring an outcome.

But there were some pleasing issues and there were some concerns with the quality of the study, there were some concerns with the quality of the guidelines.

TONY EASTLEY: Forty-three per cent of cases, patients were not getting what they really should get from their GPs. Why do you think that is the case?

STEVE HAMBLETON: Well I think there are many reasons and I think once again we will ignore the quality of the guidelines in the study. But there are so many guidelines, and there are so many guidelines with varying levels of evidence. It's hard to know whether you test against this one, you test against that one.

And also we're looking at a patient rather than a condition when you're in general practice. Now if you've got a patient in front of you, you've got co-morbidities. You've actually got to make a decision on the balance of what's in front of you, what's the best for that particular patient.

So there are lots of reasons why you might not stick to the best practice, but it certainly wouldn't be bad practice.

TONY EASTLEY: Is it that GPs are simply overworked or is it they're not educated enough in the latest techniques?

STEVE HAMBLETON: GPs are overwhelmed with enormous numbers of guidelines, with varying levels of quality. And the question is which one do you choose? How do you get access to that in a rapid way in that few minutes you've got with your patient to actually give them the best advice that's personalised to them?

And I think we are beginning to have the tools that we need to be able to do that. But we actually do need to close the gap between as I say what we know and what we do.

TONY EASTLEY: You talk there about the personal interaction between patient and doctor. Do doctors see too many patients? Do they have the individual time for each case?

STEVE HAMBLETON: Well it's always a pressure on practitioners, particularly general practitioners, to actually spend enough time with each person.
And we know from our BEACH (Bettering the Evaluation and Care of Health) data - that's a study that looks at how long GPs spend with their patients - when they do spend longer, the quality and the number of conditions is actually improved.

So our system does tend to limit the number, amount of time with our GPs. So I guess we have to look at the way we're practising.

TONY EASTLEY: Professor Braithwaite says some care would be just a little bit out of date - you're getting version two of a drug instead of version three or a GP practice that's a little outmoded.

STEVE HAMBLETON: Look I think in some circumstances there are practices that are not quite keeping up with the crest of the wave and I think we do need to make it easier for every practice to actually do that.

We actually in general practice need to demonstrate the quality of care that we're actually providing. And we need to I guess audit our practices to make sure that we are doing that. 

TONY EASTLEY: Dr Hambleton, do you think technology is the answer to bringing a lot of Australian GPs up to speed?

STEVE HAMBLETON: The great majority of GPs are up to speed. The quality of care in this country is excellent. The outcomes are very, very good. We do need in a first world country though to keep on the crest of the wave and keep improving.

TONY EASTLEY: So this idea of phone apps is a good one is it?

STEVE HAMBLETON: Well there are some phone apps that are going to be very good to help patients track what's going on in their own lives and give their GPs information about what their blood pressure has been doing, what their blood sugar has been doing.

I've often said to patients, my job is to make the diagnosis. When you've got that let's look at how we work together in looking after you in the best possible way.

And if the patients know exactly what the guidelines say about the diabetes, I'm in a position to discuss it with them. So if we've both got the same information we're going to get very good outcomes.

And I think those things, those sort of apps, those information apps, that can work for us, they can work for the patients, will be part of those tools that we need to improve outcomes.

TONY EASTLEY: Dr Steve Hambleton, thanks for joining us this morning on AM.

16 July 2012

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