We need to talk about quality in general practice

  • Mary Beth MacIsaac
  • Chun Wah Michael Tam
  • Katrina McLean
  • Mark Morgan
  • Frank Jones
  • Manabu Saito

Press/Media: Expert Comment


Article explores measurement and drivers of quality improvement in primary care. It contrasts grass-roots quality improvement to the new Practice Incentive Payment for Quality Improvement. Outcome of a workshop run by the authors at the World Organisation of Family Doctors (WONCA) are discussed.


Quality Improvement in General Practice

Period22 Jul 2019

Media contributions


Media contributions

  • TitleWe need to talk about quality in general practice
    Degree of recognitionNational
    Media name/outletMedical Journal Australia Insight Plus
    Media typeWeb
    DescriptionWE ARE a mix of academic and full time clinical GPs. Along with our practice colleagues, we are enthusiastic about delivering high quality care. We teach medical students and registrars, meet regularly in our practice teams to discuss challenging clinical scenarios, undertake in-practice small group learning, and bicker over our patient recall systems with a fervour usually reserved for debating who will win the State of Origin.

    We hoped that perhaps the Australian Government was interested in quality general practice too when they announced the Practice Incentive Payment Quality Improvement (PIP QI), which begins on 1 August 2019. So why were we left feeling puzzled and somewhat disempowered?

    General practice care is a complex system. Even something notionally simple such as antihypertensive therapy is actually a complicated balancing act. We consider not only the blood pressure reading but also the patient’s cardiovascular risk factors, medication tolerability, cost, and the patient’s lifestyle. We think about what is behind the readings (the second cup of coffee after a sleepless night, the argument with their spouse). We think about whether starting a new medication is the most important thing we can do for this person today, and whether we need to explore and manage what is really going on with them (the hidden agenda behind presenting for a blood pressure check). And we understand that how we interact with this patient, and the choices we make in designing our clinical practice workflows, feeds back and influences the running of the practice in ways that can be unexpected.
    Producer/AuthorMedical Journal Australia (MJA)
    PersonsMary Beth MacIsaac, Chun Wah Michael Tam, Katrina McLean, Mark Morgan, Frank Jones, Manabu Saito