Introduction
Most of us have a pretty good idea about what
we think makes a good GP. Most of us expect good
access to a GP when we need it. We also wanted
good interaction with our GP. We wanted to be
listened to, and to be taken seriously and we
also want our doctor to be on time.
There are three main ways to ensure you're on
the track to finding a good GP
- Find someone who is recommended
- Find someone who is recognised by the
profession (on reputation and study)
- Find someone who is interested in
you
Asking friends or family, who they recommend
can be one of the most useful ways of finding a
good GP. When you find someone who you think
you'd like to see, they should have RACGP after
their name.
GPs can undertake particular postgraduate
study in general practice. These GPs have gained
the Fellowship of the Royal Australian College
of General Practitioners and they will have
FRACGP also after their name.
Your GP is a professional, whom you want to
be sure is capable of looking after your health.
Medical professionals provide an important
service within society and have undertaken a
significant academic study of health, along with
extensive training in health care.
Two remaining points when seeking out a good
GP
- You need someone you can afford to
see
- You need someone who is willing to
learn
The best GP is no good if you can't afford
them, and the cheapest GP is no good to you, if
they are someone you don't want to see.
The GP you're looking for doesn't have to
know all about your particular condition, but if
they're willing to learn from you and from
others, they can be streets ahead already. If
money is an issue you should be able to talk to
your GP about that.
What to expect when you find your GP?
There are a number of things you can expect
the new GP to do for you over the first couple
of visits.
You can expect the GP to take your full
history as well as your relevant family history.
Your GP should also carry out a relevant
clinical examination, as well as any routine
health checks according to your age and sex.
This includes pap smears for sexually active
women and prostate checks for men over the age
of 50.
Lastly, all good GPs keep one eye on
preventive health, such as annual flu
injections, risk of heart disease by considering
cholesterol, blood sugar, what your mental
health is like, how much you smoke, drink and
exercise and any other issues considered
appropriate because of your particular personal
and family history.
Standards in general practice
GP Standards help guide GPs and their staff.
For example, when providing a quality service to
you, one example of the standards is practices
must provide reminders for patients. Another
example is practices must provide facilities for
out-of-surgery and after-hours care with tiered
options.
A new GP Standard is practices can provide
secure electronic communication with
patients.
Practices that are willing to measure how
well they come up to the standards undergo
accreditation. Look for the logo in the practice
that says the GP Practice you attend is
accredited.
How can you get the most from your GP?
Now that you have found your GP. How do you
go about getting the most from the consultation
time you have with that GP?
Generally consultation time with GPs are
either 20 minutes or 40-45 minutes. You are able
to let the office staff or receptionist know if
you have time pressures (eg., have to leave at
2.30 to pick the kids up from school), and they
should also do the same (Dr is running 10
minutes late behind today would you like to
reschedule?).
As strange as it sounds, one of the best
things you can do for yourself and your GP is to
make a list. Become a partner in your
healthcare, and make a list of the things you
need to talk about with your GP. Flag the most
important thing on your list with your GP early
on in the consultation. If there is insufficient
time to address everything on the list, you can
decide together what to look out in this
consultation and what to leave for later.
Some new initiatives to help patients and
GPs
These are referred to as EPC items or
enhanced primary care items. These are
activities like GP management plans
(GPMP), team care arrangements (TCA) and
home medication reviews (HMR).
GP management plans offer incentives
to GPs to prepare and review patient management
plans for patients with chronic medical
conditions. For patients requiring
multidisciplinary care from a range of
specialists, your GP can also provide you with
documents that let you get a Medicare rebate for
some allied health attendances. This is
recognised by Medicare, as a Team Care
Arrangement.
A home medication review assesses a
patient's medication management needs and then
refers the patient to a community pharmacist for
this review. The pharmacist visits the patient
at home, where the pharmacist, patient and
anyone else the patient desires to be part of
the discussion can discuss prescribed
medication, over-the-counter medication, and any
other drugs or active foods the patient uses for
their health. With the patient's consent the GP
provides relevant clinical information for the
review. The GP then discusses with the reviewing
pharmacist, the results of the pharmacist
review. The suggested medication management
strategies are reviewed by the GP, who develops
a written medication management plan following
discussion with the patient.
Improved access to allied health
practitioners like psychologists have been
added to that toolkit for GPs. The allied health
professionals that can provide services include
psychologists, social workers, mental health
nurses, occupational therapists, Aboriginal
Torres Strait Islander health workers
dieticians, diabetic educators, podiatrists,
exercise physiologists and chiropractors.
On the horizon and mentioned in the 2006
budget, there will be a special Medicare item
number, to fund planned annual health reviews
for all people, aged 45 with a chronic
condition.
Studies have demonstrated that having a
regular GP improves an individual's health,
decreases the likelihood of hospital admission,
decreases the risk of readmission and improves
coping skills and mental health. For GPs, having
patients with complex and even rare conditions
permits use of skills that distinguish general
practice from consultant practice. We get to
know you, we age together, and we seek more
knowledge to be able to provide the best
health-care for you. Along with gains for the
patient there is an increase of professional
satisfaction for the doctor as well. We can
create a very satisfying and fruitful
partnership together.
For more information
Dr Linda Mann is a principal of Inner West
General Practice, an award winning general practice
(Best practice 1988, Innovation award 2004). Linda
practices in Hay with the Royal Flying Doctor
Service Women’s GP project, and at Balmain
General Practice Casualty.
