GPs fitting more into patient consultations

GPs are fitting much more into patient consultations than they were a decade ago but the average length of the consultation has stayed the same, research led by the University of Sydney shows.

“Our GPs are getting busier and busier,” said lead author Associate Professor Helena Britt from Sydney Medical School.

“‘We are seeing our GPs more often than we were a decade ago, and the GPs are also fitting more into their consultations. For example patients are presenting with more issues, GPs are managing more problems, and doing more tests and procedures — yet the time spent in the average consultation has stayed steady at about 15 minutes.”

Two reports published are titled General practice activity in Australia 2011–12 and A decade of Australian general practice 2002–03 to 2011–12, and provide data on the activities of our GPs and the care of their patients. 

The data comes from the Bettering the Evaluation and Care of Health (BEACH) program which continuously collects information about clinical activities in general practice in Australia. Associate Professor Britt is director of the program.

“In 2011-12, 83 percent of Australia’s 22.6 million population saw a GP at least once, and Medicare paid for an average 5.4 visits per person (122.5 million in total),” Associate Professor Britt said.

The number of procedures done at GP visits increased when Medicare started to pay for some procedures done by practice nurses, under the supervision of the GP.

In 2011-12 nurses did about one third of all the procedures recorded in BEACH.

In contrast to the increase in the number of procedures following the involvement of nurses in consultations, since the nurses’ involvement GPs give less advice, education and counselling about exercise, nutrition and weight.

“That trend is continuing so we hope that the important role of exercise and dietary advice is being picked up by the practice nurses at, for example, independent meetings with patients as part of their chronic disease management, or as part of diabetes education,” said Professor Britt.

“The trouble is we don’t have information about these nurses’ work outside GP-patient encounters. Practice nurses’ independent activities represent a growing gap in our understanding of the content of general practice care of the population.”

This year the researchers also investigated which problems are referred to certain specialist groups, an area in which there is virtually no information available worldwide.

They found that osteoarthritis accounted for one in five new GP referrals to orthopaedic surgeons, ischaemic heart disease accounted for one out of five referrals to cardiologists and diabetes for one out of six referrals to ophthalmologists.