GPs visiting aged care homes say it’s a “frustrating experience”

The study ‘Australian General Practitioner Attitudes to Residential aged Care Facility Visiting’ by the University of Wollongong (UOW), reveals that while many GP’s enjoy visiting residents in aged care, many are also finding the visits a “frustrating experience”.

Lead investigator on the research study, Clinical Associate Professor at UOW’s School of Medicine and practicing GP, Dr Russell Pearson, says understanding GP’s attitudes towards aged care visits was “vital” in order to identify and resolve inefficiencies and ensure the continuation of GPs providing care in those facilities.

“In 2013 I saw an advertisement for practices looking for GPs which mentioned no nursing home visiting as an incentive in joining the practice, and I was astonished,” Dr Pearson explains.

“It made me wonder had the people writing the ads accurately captured the mood of australian GPs?

“So, we searched the literature which suggested that the sustainability of the Australian GP residential aged care facility workforce is under threat.”

Dr Pearson says the literature suggests that only about 50 percent of Australian GPs currently visit residential aged care facilities, with a heavy reliance on older male GPs.

He notes that only 40 percent of early career GPs are visiting nursing homes, saying that this research identified barriers to GP participation in residential aged care facility visiting, which were “managerial rather than attitudinal”.

From there, Dr Pearson and his fellow researchers spoke with GPs and GP registrars working in rural and regional New South Wales, using focus group discussions and one-on-one interviews.

The findings of their work showed that GPs generally enjoyed caring for patients in nursing homes and felt it to be an integral part of general practice, with research participants saying:

“It’s part of your duty of care to look after them” and “We should be looking after our elderly well and with kindness and good treatment”.

Dr Pearson also made note of the frustrations experienced by many visiting GPs, saying what added to this frustration was the belief that the work was “poorly remunerated” relative to the work they undertook at their surgery.

“The overwhelming finding was the frustration that engaged GPs experienced in their visits,” he says.

“For many GPs, the experience of visiting residential aged care facilities was one of hide and seek: seeking out the patient, the nurse, their notes and medication charts.

“GPs felt they were financially disadvantaged by their commitment to visiting residential aged care facilities [and] younger GPs were hesitant about engaging in this work because many were inexperienced or educationally unprepared because of the lack of residential aged care facility visits during their training.

“Nevertheless, the GPs enjoyed the work and felt a sense of duty to continue the care of this frail and vulnerable group.”

Aged care peak body Aged and Community Services Australia (ACSA) has stepped forward to stand with GPs, with ACSA Chief Executive Officer (CEO) Pat Sparrow saying the organisation “agrees wholeheartedly” that residents of aged care facilities deserve high quality health care.

“Residents have the right to the GP of their choice and many want to remain with the doctor they were seeing when they were living in the community,” Ms Sparrow explains.

“It is frustrating that there are difficulties in getting GPs to residential aged care to ensure residents get the same quality of primary health care as all Australian citizens.

“This has been an issue for some time and many ideas have been put forward to address this issue.  

 “One thing that would assist across all health disciplines is if training and education included placements in residential facilities so practitioners can experience and see how important and rewarding it is to work in aged care.

“Understanding how and what aged care is funded to deliver would also assist in allowing GPs and residential care providers to work more effectively together.”

Dr Pearson says further research will be undertaken by the research team to focus on all perspectives.

“The obvious criticism of this research is that it’s focussed on the GP perspective,” he explains.

“We are now undertaking additional research to include the experience of residential aged care facility staff, residents and families, and GPs.

“This next stage of research enables us to have a 360-degree view of the care of this vulnerable population.”

ACSA has also welcomed the further examination of GP visits in aged care from the perspective of the staff, residents and their families saying it will “inform how we can all do it better”.