Neglecting general practice research risks poor health outcomes

AUSTRALIANS may experience poorer health outcomes unless recognition and funding of general practice research is boosted with investment in training and funding, according to the authors of a Perspective published online today by the Medical Journal of Australia.

“Over eight in 10 Australians consult with their GP at least once per year, and two million people are seen each week in general practice,” wrote the authors, led by Dr Jo-Anne Manski-Nankervis, an Associate Professor in General Practice at the University of Melbourne.

“General practice, a medical specialty, is the first point of access to the health system, providing longitudinal care for all.

“A GP must have a good working knowledge of 167 problems to cover 85% of the conditions that they see most frequently, and management of multimorbidity has become the norm.

“The number of general practices appears to be declining, practices are becoming larger, and the proportion of GPs who are practice owners is decreasing.

“General practice research is key to optimising health care in this evolving context, but needs to be supported by the profession, funders and our professional colleges.”

Despite the importance of general practice to health outcomes, the current Medical Research Future Fund 2019-2020 budget allows for only $5 million out of a total $392.5 million to be specifically invested in general practice research, according to Manski-Nankervis and colleagues.

“The proportion of National Health and Medical Research Council funding to primary care research has [also] been consistently low.”

“Research in this setting is required as never before, with an ageing population, increasing rates of multimorbidity, and management continuing to move out of the hospital and into the community setting,” they wrote.

“There is no other academic specialty that will focus on generalist care in the community, and general practice is integral to research translation. Without general practice, the health outcomes of the population will be poorer and less equitable, and associated with increased health costs.

“A lack of focus on general practice research and academic opportunities will have a flow-on effect to the recruitment of new GPs. To build interest in general practice more broadly, attention needs to be paid to medical students who often believe there is little intellectual challenge in the profession and a lack of academic opportunities.”

Manski-Nankervis and colleagues concluded that “recognising and investing in the value of general practice research will require a systems approach that includes medical student training, vocational training, and support of research infrastructure and GP clinician-scientists to enable research and research training in general practice and translation into practice and policy”.

“This investment in general practice research and infrastructure should reflect the size of general practice in Australia, the population it serves, and the proportion of the associated Medicare spend.”