Reflections on the history of general practice in Australia

Abstract

Summary General practice has experienced change over the past century driven by a variety of influences, the most important of which have been changes in the health needs of the population, the organisation of the workforce, and medicine itself. Over this time, general practice has developed as a profession through education and, ultimately, recognition of its specialist qualifications. There has been increasing organisational sophistication at the practice, regional and national levels. Despite contested scope of practice and vision of its future, general practice's place in the health system as a whole has been increasingly recognised and affirmed.

A review of the growth and development of Australian practice nursing: Insights for the dietetic workforce

“…From the literature identified, the influence of the growth and development of the practice nurse role and workforce encompassed: Category 1: Government Funding Support, encompassing government funding initiatives that furthered the development of the role; Category Government funding: Of the 102 papers included, 29 were related to government funding as a key driver to practice nurse role development, such as specific MBS item numbers claimable by medical practices for tasks fulfilled by a practice nurse, 15,19,52,66,68,91,96,100,108,111 funding for the creation of practice standards, 105 education and professional development funding, 48 and programs designed to empower the primary care workforce as a whole, where practice nurses play a vital role including the Workforce Incentive Program, 113 formerly Practice Nurse Incentive Program, 11,20,75,110,113 Mental Health Nurse Incentive Program, 34,58,59,89 Chronic Disease Management, 18,50,88,100,117 GP 'Super Clinics' 81 and the 'Close the Gap' initiatives. 112 A further 12 papers related government funding as a contributor to, but not the main driver of, practice nurse role development.…”

“…14 The chronic disease management item numbers opened up opportunities for dietetics to be better utilised in primary care to address the growing prevalence of chronic disease. 18,19 Additionally, the Practice Nurse Incentive Program, now known as the Workforce Incentive Program, was initiated in 2012 (coinciding with the rescinding of other practice nurse MBS item numbers), and has also enabled practice nurses, Aboriginal and Torres Strait Islander health workers, and allied health professionals to achieve a higher presence in Australian primary care. 20 Despite the Australian government intention for funding to better support and involve the dietetics workforce in primary care, dietitians still arguably go largely unrecognised as frontline primary care workers compared with their nursing colleagues.…”

“…Additional item numbers for practice nurses and allied health professionals were implemented in the chronic disease management initiative in general practice in 2005 14 . The chronic disease management item numbers opened up opportunities for dietetics to be better utilised in primary care to address the growing prevalence of chronic disease 18,19 . Additionally, the Practice Nurse Incentive Program, now known as the Workforce Incentive Program, was initiated in 2012 (coinciding with the rescinding of other practice nurse MBS item numbers), and has also enabled practice nurses, Aboriginal and Torres Strait Islander health workers, and allied health professionals to achieve a higher presence in Australian primary care 20 .…”

Educational models, participant experience and outcomes of a diploma course in practice management for Aboriginal Medical Services: a qualitative study

“…The practice manager's (PM's) role in Australian general practices has expanded over the past several decades. PMs deal with increasing complexity of practice administration in response to regulatory, clinical and population health changes (Harris and Zwar 2014). The complexity of patient morbidity seen in these practices has increased markedly (Britt et al 2016a).…”

A best practice health governance framework for integrated care: an exploratory study

“…To meet changing population health needs, there has been increasing organisational sophistication regarding primary care at the practice, regional and national levels in many countries (Bienkowska-Gibbs et al, 2015;Harris & Zwar, 2014). This has included the development of specific structures to organise the regional planning and provision of primary care services for a population across a geographical area.…”