17 November 2023
Health of the Nation report: Time for a change in general practice
The following statement can be attributed to Dr Karyn Matterson,
President, General Practice Registrars Australia (GPRA):
The release of the Health of the Nation 2023 report by the Royal Australian College of General Practitioners (RACGP) this week has further generated essential discussions about the attraction and retention of the general practice workforce. While the report offers a thorough analysis of the present state of general practice, its true significance lies in igniting a dialogue about the future — a future which requires substantial change, innovation, and a shift in mindset.
The report offers a wake-up call about what we need to focus on, and a poignant reminder that the sector urgently needs to pivot towards a forward-thinking approach. Merely topping up and band-aiding existing systems with short-term incentives won’t suffice. We can’t just continue to invest in old systems which people within general practice know are not sustainable and not fit for purpose to meet the needs of quality patient care and practice. This report can act as a guiding light, offering crucial insights into where our focus should lie for genuine, impactful change.
One important aspect to take from the report is that students are generally positive about general practice, and our junior doctors are positive about being future GPs. As leaders in the sector, it’s our responsibility to reassess how we present and frame this profession to align with their aspirations and expectations.
The General Practice Students Network (GPSN), with nearly 5,000 members across 20 universities, stands as a testament to the enthusiasm and interest in general practice among budding medical professionals. Reinstating funding and fostering collaboration between GPSN, its members, the sector and peers could unlock a wealth of innovative ideas for the future of healthcare.
It is disappointing to learn that most established GPs wouldn’t recommend general practice to junior doctors. The reluctance of experienced GPs to promote general practice to GPs of the future highlights the urgency for meaningful near-peer initiatives to ensure positive placements and mentorship. Any future new near peer initiatives, which GPRA fully supports, will need to make sure matching process and quality positive placements are identified.
Additionally, the report underscores the desire for flexibility in employment among the future workforce—a trend reflective of the changing preferences and career aspirations of younger generations. The emergence of portfolio careers among them necessitates a rethink of our traditional models of private general practice.
The report’s revelation about burnout among participating GPs should serve as an eye-opening call for systemic reform. We need a fundamental shift in our mindset and business approach – a cultural change which embraces new technologies to propel primary care into the future.
GPRA is the independent national peak for future GPs, and the release of the report again spotlights the issues our members want addressed, including access to parental and other entitlements such as study and exam leave. It’s time to address the system barriers so patients into the future continue to access highly qualified GPs.
Australia’s recruitment and retention strategies would go a large way to be solved by recognising the value of the speciality of general practice and implementing base rate parity policy to ensure that doctors in GP training receive the same base rate as their counterparts in other non-GP specialty training programs. This can be done immediately and would represent a tangible, positive step forward in improving attraction to the specialty of GP.
As one GP in the report states: “My wonderful junior colleagues spend eight years at university, have huge debts, young families, and cannot afford to practice in a bulk-billing scenario whatever their sense of social justice.”
This simply cannot go on.
I think the report signifies a stage gate — a doorway beckoning us to step through and to start thinking outside the box. The current top-down approach won’t work. It’s crucial we all work together to engage with the future, enabling us to think differently and reimagine the landscape of this wonderful profession.
Collaborating with industry leaders and harnessing the wisdom of future GPs can steer us towards a future where quality primary care thrives. The time has come to pave the way for a sustainable and innovative healthcare landscape – one that fulfills the needs of both practitioners and patients.
At GPRA, we are putting out a call to host a future business of general practice roundtable for our members to be engaged with other stakeholders and thinkers outside the immediate health arena, and identify solutions to build general practice for the future. We are best placed to do it, as our members are the future – it’s time for the decision makers to back the next generation to achieve this.
Let’s harness the wisdom of future GPs. We all want a viable GP sector which leads to quality primary care. Now’s the time for action.
Dr Karyn Matterson
BNutrDiet(Hons) FRACGP FARGP-RG EMC DAME GAICD