Providing healthcare for people with chronic illness: the views of Australian GPs

Med J Aust. 2003 Jul 7;179(1):30-3. doi: 10.5694/j.1326-5377.2003.tb05414.x.


Objectives: To explore general practitioners' views on chronic-disease care: the difficulties and rewards, the needs of patients, the impact of government incentive payments, and the changes needed to improve chronic-disease management.

Design: Qualitative study, involving semi-structured questions administered to 10 focus groups of GPs, conducted from April to October 2002.

Participants and setting: 54 GPs from both urban and rural practices in New South Wales and South Australia.

Results: Consistent themes emerged about the complex nature of chronic-disease management, the tension between patients' and GPs' goals for care, the time-consuming aspects of care (exacerbated by federal government requirements), and the conflicting pressures that prevent GPs engaging in structured multidisciplinary care (ie, team-based care involving systems for patient monitoring, recall, and care planning).

Conclusions: Structured multidisciplinary care for people with chronic conditions can be difficult to provide. Barriers include the lack of fit between systems oriented towards acute care and the requirements of chronic-disease care, and between bureaucratic, inflexible structures and the complex, dynamic nature of GP-patient relationships. These problems are exacerbated by administrative pressures associated with federal government initiatives to improve chronic-illness management. Changes are needed in both policies and attitudes to enable GPs to move from episodic care to providing structured long-term care as part of a multidisciplinary team.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease / therapy
  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Chronic Disease / therapy*
  • Cross-Sectional Studies
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Health Planning / trends
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Patient Care Team / organization & administration
  • Physician's Role
  • Physician-Patient Relations
  • Physicians, Family / statistics & numerical data*
  • South Australia