Fitting more in patient consultations

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

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

“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 remains steady at about 15 minutes.”

Two reports published last week by general practice activity in Australia 2011-12 and A decade of Australian general practice 2002-03 to 2011-12, provide data on the activities of Australian 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 within general practice in Australia.

“In 2011-12, 83%  of Australia’s 22.6 million population saw a GP at least once, and Medicare paid for an average 5.4 visits per person (1 22.5 million in total),” director of the program, Associate Professor Britt, says.

The number of procedures performed 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 performed 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,” Professor Britt said.

“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 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.