New report oversimplifies the work GPs actually do: RACGP President

Doug Hendrie

19/12/2018 12:06:22 PM

Dr Harry Nespolon criticised a report stating the top reasons for visiting a GP are to access a prescription, review or follow-up, and upper respiratory tract infections.

Dr Harry Nespolon said it is ‘ridiculous to think the most common reason people visit their GP is a repeat prescription’.
Dr Harry Nespolon said it is ‘ridiculous to think the most common reason people visit their GP is a repeat prescription’.

RACGP President Dr Harry Nespolon has questioned the quality of data in NPS Medicinewise’s General practice insights report 2016–2017.
While the report found accessing a prescription is the top reason to visit a GP, it only accounted for 3.96% of consultations.
Dr Nespolon told newsGP the report oversimplifies the complex work GPs actually do in day-to-day practice.
‘It’s ridiculous to think the most common reason people visit their GP is a repeat prescription; it’s one of the rarest reasons, to have people show up just for a repeat,’ he said.
‘A repeat script is an action, not a diagnosis. When people say they’re just here for a repeat, they’re often the ones here for a full 15-minute consultation.’
Dr Nespolon gave the example of a patient arriving for a repeat prescription for anti-depressants, in which case GPs would review the patient’s progress, ask how life is going, and check that the medication and dosage are still appropriate before providing the repeat.
‘This report does nothing for GP confidence in NPS Medicinewise and the way it deals with its data,’ Dr Nespolon said.
In part, the issue stems from the fact time-poor GPs may record the same condition using different terms, or even simply listing ‘prescription’ when the actual long-term issue is, for example, hypertension.
‘This relies a lot on doctors putting in the right diagnosis,’ Dr Nespolon said.
‘Yes, we need to improve the quality of diagnoses GPs put into their electronic medical records. [But] this data shows concerns about the quality of data used to potentially pay doctors.’
Dr Nespolon warned that similar data quality issues may affect the proposed Quality Improvement Practice Incentive Payment (QI PIP) scheme for GPs.
‘This doesn’t bode well for QI PIP,’ he said.

data general practice NPS Medicinewise

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Dr Evan Wayne Ackermann   19/12/2018 8:23:28 PM

This is auditing of GP records without a GP oversight.
They are counting "episodes" when a request for a repeat prescription is recorded in a medical record without the patient presenting (eg via a phone request).

Jan Sheringham   20/12/2018 10:48:57 PM

Agreed Evan, and likely includes episodes of writing repeat scripts for RACF residents as requested by their pharmacist, often without a visit on site! As a locum, those who present “just for a script thanks” often require significant review of systems, medication use and target organ changes to ensure ongoing safe prescribing! So often these contacts turn into item 36 visits because of complex co-morbidities which have not been reviewed for some time! It behoves us all to code our visits with ALL MATTERS ADDRESSED on every occasion as an example of complex record-keeping., and to ensure regular system reviews occur.

Dr Lamia Nakhal   21/12/2018 9:02:09 AM

This is yet again an insult to the work we do, I hope those who write those reports don t come to me as patients. Then I will give them. a lecture and tell them about my work.It is vey sad and I hope our RACGP and our president stands strongly about those people who undermine us. Honestly, I am to a point where I just want to leave this job because I am so tired of "stupid"people and"stupid comments".Say a word, Mr President!!!

Dale van der Mescht   21/12/2018 9:54:53 AM

I’ve realised that there is no point in caring what these reports say. Whether people believe that we are just script writers or “Medicare abusers” makes no difference to the job we actually do. It makes us as a profession look silly when we keep defending ourselves. We know what we do and so do the patients that benefit from our care. We should as a whole stop pandering to these stupid reports and just get on with what we do.

Braj Raj Pande   21/12/2018 11:04:38 AM

To make people and Governments realise what we do all GPS whole to Pen Down Strike for just 1 day
The chaos resulting from that would make realise the value of GPs, who work tirelessly for a fraction of cost as compared to any other speciality or hospitals.

joveria   22/12/2018 1:01:38 PM

First request is please stop calling us GP/general practioners/(not specialists). The complexity of care we provide cheap as chips; tradesman earn twice more then me.
Call me a Family Physician please. After 6 years of basic degree and 5 years of specialist training I am still called general? Also day by day Medicare is slashing and decreasing the special item numbers and just this year we lost so much with changes in the surgical item numbers. I had to take my son to an OT and the amount that was charged for the services was just shocking. 600 $ for a report. I feel "GPs" the most underpaid and undervalued profession in Australia.

Antoinette   20/01/2019 8:00:14 PM

Talk about my most recent day at work - a cough or cold would have been welcome and simply wonderful. The day started at 0615 with a rotational vacuum in theatre for a multi with an unprovoked fetal bradycardia, resulting in a healthy baby and intact perineum; after ward rounds (mostly postnatal) clinic was delayed due to having to cannulate a presumed septic 5 week old baby and transfer to a paediatric facility; ECV and I&D thrombosed external haemorrhoids at midday after what was left of morning clinic; then a fully booked afternoon clinic which included 6 week immunisations, snipping a tongue tie and tying off a preauricular skin tag, as well as several other fascinating cases I've forgotten. The JFPP students and I then went to a local koala sanctuary in true rural spirit for an evening stroll. The last I heard about primary care being boring was in medical school from the GP tutors - it couldn't be further from the truth and is possibly the most rewarding career.


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