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The key ingredients for revitalising General Practice

Friday December 20, 2019

Dr Simon Torvaldsen, Chair, AMA (WA) General Practice Group

Traditionally, December is the time when we reflect on the achievements of the year – the highs and sometimes, the lows. Hopefully, I have been keeping you updated on the issues. General Practice has been through a difficult time in the past few years with ongoing relative cuts to Medicare rebates and no new funding. The AMA has successfully defeated a number of major threats, which has prevented the collapse of General Practice, but not in itself got us much further ahead.

As I wrote last month, there have been some positives this year – funding for patient registration, which is set to expand, as well as more money into the PIP and some rural telehealth. We are working on more areas.

The Wound Management Working Group that I chair has also released a draft report for public comment. This is strongly focused on General Practice and recommends new wound assessment items for GPs, reinstating practice nurse items for chronic wound care and the introduction of a consumables scheme for chronic wounds similar to the current vaccine scheme, where the government supplies a range of products at no cost for use by eligible patients.

This is all a long way from being accepted and implemented by government, but does show that General Practice is seen as the vital centre of the healthcare system.

So what are the other ingredients for revitalising General Practice?

The answer is broadly two fold, firstly to make General Practice a rewarding and well-regarded career, both satisfying and remunerative. Secondly, to have an easy and attractive training pathway.

The answer to the first part encompasses all the aspects I have discussed this year, in particular ensuring General Practice remains at the centre of the healthcare system, with payments and incentives focused on rewarding quality practice, not forcing rapid turnover and penalising those who spend necessary time with their patients.

The second part also involves two aspects. The first is a well-run, well-structured training program that is attractive and flexible to trainees and provides the skills necessary to practise good quality and rewarding medicine.

Our State is fortunate to have Western Australian General Practice Education and Training (WAGPET). No training program is perfect and the AMA holds imperfections to account, but I believe that WAGPET leads the way nationally and is getting runs on the board for GP training in WA, both in metro and rural areas.

The other aspect is being able to enter the training program. WAGPET must ensure that it recruits trainees with the necessary background and experience to enter the program. This sounds simple, but in fact is not easy to achieve, as no doubt many young doctors will attest.

Dr Paul Myhill has been doing a lot of work through the WA Department of Health in analysing workforce needs as well as the GP training pathways. Although an endocrinologist, he has done fantastic work in this area and is considered one of WA’s strongest supporters of General Practice.

Paul’s research has shown that despite graduating more doctors in WA and our training program, we will still face a shortage of GPs going into the next 10 years. He has also identified blocks to RMOs intending to be GPs obtaining the terms they need to enter the training program.

Paul has been successful in persuading the WA Department of Health to restructure hospital training to prioritise the needs of those who want to be GPs and maximise their chances of successfully training as a GP. WA once again leads the nation in this.

I am therefore hopeful that going into the future, you will have a more rewarding, better paid career and an easier pathway into it. I am going to spend next year making sure we progress this and that young doctors have the same opportunities I have had for a long and worthwhile career in General Practice.

Email me at: simon.torvaldsen@amawa.com.au