Title We need to talk about quality in general practice Degree of recognition National Media name/outlet Medical Journal Australia Insight Plus Media type Web Country Australia Date 22/07/19 Description WE 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/Author Medical Journal Australia (MJA) Persons Mary Beth MacIsaac, Chun Wah Michael Tam, Katrina McLean, Mark Morgan, Frank Jones, Manabu Saito