Neglecting general practice research ‘risks poor health outcomes’

‘High quality general practice research is important to help describe general practice activity, drive policy decisions, inform new models of care and optimise the care that GPs provide to their patients and community.’
 
That is Chair of the RACGP Expert Committee – Research (REC–R), Dr Jo-Anne Manski-Nankervis. She is an Associate Professor in General Practice at the University of Melbourne and lead author of a new Medical Journal of Australia article.
 
In the article, the authors warn that unless recognition and funding of general practice research is boosted with investment in training and funding, it could lead to negative flow-on effects such as worse health outcomes for patients — as well as the profession as a whole.
 
GPs are required to have good working knowledge of 167 medical problems, covering 85% of the conditions that they see most frequently.
 
Faced with an ageing population, increasing rates of multi-morbidity, and management continuing to move out of the hospital and into the community setting, Associate Professor Manski-Nankervis and colleagues argue that ‘research in this setting is required as never before’.  
 
Associate Professor Manski-Nankervis told newsGP the vital role GPs play in the healthcare system has been demonstrated by the recent bushfires and ongoing coronavirus pandemic, and there is a need to understand how to best support general practice so that GPs can continue to step up.
 
‘Research can really help answer those questions — the good things that are happening, as well as some of the struggles and some of the pressures that general practice is experiencing,’ she said.
 
‘[Otherwise] we’re not going to be prepared for the next bushfire or the next pandemic. And they will come, unfortunately.’  
 
More than eight in 10 Australians consult their GP at least once per year and two million people are seen each week in general practice. Yet, only $5 million of this year’s Medical Research Future Fund budget of $392.5 million has been invested in general practice research.
 
RACGP President Dr Harry Nespolon told newsGP many GPs are conducting research while practising without the ‘recognition or compensation’ they deserve.
 
‘For too long research in general practice has been shockingly undervalued,’ he said.
 
‘Yet the central importance of general practice has been particularly evident during the bushfire and COVID-19 crises.
 
‘When GP research is supported, doctors are able to discover new ways to improve general practice and patient care – and people all over Australia stand to gain in improved health and wellbeing.’
 
The authors fear the lack of academic opportunities could have a flow-on effect on the recruitment of new GPs.
 
‘At the moment, often if you’re working as a doctor in a tertiary hospital, you’ll actively have your supervisor come to you and say “I’ve got this project, do you want to consider doing a PhD?” – that doesn’t really happen in the general practice setting,’ Associate Professor Manski-Nankervis said.
 
Due to this, many young doctors may not be aware that research is an option in general practice.
 
‘Moving forward, we need to be able to provide opportunities for GPs to engage in research in a way that’s meaningful to them in their practice,’ Associate Professor Manski-Nankervis said, adding it must be undertaken ‘in a way that they can engage with research activities that isn’t to the detriment of them running their general practice and their businesses’.
 
Associate Professor Manski-Nankervis understands this firsthand, having received a PhD scholarship and grants from the RACGP Foundation.
 
‘Those have been critical to my development as a researcher because it’s very difficult to undertake high quality research if you don’t have adequate funds to support that,’ she said.
 
‘Without that funding, I wouldn’t have a career in general practice research at the moment. It’s that black and white really.’
 
As of January 2022, vocational training will be transitioned from the Federal Department of Health to the RACGP and the Australian College of Rural and Remote Medicine, which Associate Professor Manski-Nankervis sees as a chance to provide a greater foundation for a supported path in general practice academia.
 
‘That provides us with a real opportunity to explore how research can become more embedded in those programs and also to understand how we can offer more flexibility so that GPs who want to undertake research training, concurrent with their general practice specialty training can be supported to do that,’ she said.

‘We have been having discussions over a very long period of time about the lack of support for general practice research, academic pathways and funding. Now is the time to make a significant change.’
 
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