Is General Practice for You?

 

Is general practice intellectually challenging? Isn’t it mainly coughs and colds or referrals to specialists?	General Practice is extremely challenging for the very reason that one must be able to diagnose and manage the problems of any patient who walks through the door. These can range from tonsillitis to pulmonary oedema, from broken bones to psychotic depression, from skin rashes to bowel cancer – sometimes all on the one day. It is the GP’s job to detect the life threatening causes among the non-specific presentations and to refer appropriately when needed. Specialists receive the cases already sorted out by GPs. GPs in rural and remote areas often have the opportunity to maintain procedural skills such as obstetrics and anaesthetics.
Will I still be doing the same thing in ten years time? Won’t I be bored?	Medicine is changing at a rapid rate and the way practice is carried out does not stand still. Many GPs develop special interests which change throughout their careers and there is plenty of scope to do this. GPs can maintain their skills to help all patients while also developing areas of expertise in such things as sports medicine, minor surgery, mental health or palliative care. Their skills also allow them to be involved in areas such as Public Health and Aboriginal Health.
Is general practice too difficult? Do I have to be good at everything?	GPs need to know how to respond to every problem that presents. However, this does not mean their knowledge needs to be at specialist level in every area. Even in rural areas there will be resources available even if they are at the end of a phone or aeroplane runway. A crucial skill for all GPs is to be able to recognise their limitations and to use other resources appropriately.
What about all the red tape in practice these days?	Administrative requirements have certainly increased over the years. However, some of these have been of benefit to the quality of health care in general practice. It is also the case that most practices now have practice managers to deal with these issues so that GPs can spend more time utilising their medical skills.
Will I earn enough in general practice?	Minimum salaries for GP registrars are guided by the GPRA Minimum Terms & Conditions. Once you have completed your training, earning potential can increase significantly, especially in rural areas where doctors tend to see more patients and do significant amounts of overtime and hospital and procedural work. GPs can choose to be paid sessional rates or (more commonly) as a percentage of income generated and general practice is flexible enough to accommodate people’s priorities in terms of lifestyle or income.
Will it fit in with my partner’s career?	General Practice is the most flexible specialty in terms of working hours or geographical location.
Is the training flexible enough to fit in with family commitments and other interests?	Registrars can apply for part-time training if required and leave is available. They are expected to undertake their training terms within the geographical area of the regional training provider and all registrars must complete a rural term. Rural Pathway registrars must complete their general practice terms in RA 2-5 locations. Rules regarding any transfers between regions (for educational or other purposes) can be found on the AGPT website under Policies www.agpt.com.au
Where can I work?	Once you have vocational registration and a provider number you can work anywhere in Australia, unless you are under the 10 Year Moratorium and restricted to areas of need as defined by the Australian Government.
Who employs me or do I work for myself?	Most GPs work in small private practices. The number of solo practices is decreasing and practice size is tending to increase. You can work as an assistant, an associate or a partner in a practice. Some GPs like the challenge of owning and running their own practice and others prefer to avoid the business side of practice. In the capital cities there are now larger practices owned by corporate businesses. It’s up to you to decide what structure suits you best.
I’ll miss the hospital environment. Isn’t it very isolating in private practice?	Private practice can be isolating for any specialists who only work in the private sphere. However, general practitioners tend to work in group practices and, increasingly, also have other allied health and nursing staff working from their practices. 25% of GPs also work in hospitals and rural GPs often have the opportunity to work in public and private hospital settings.
How will I feel being “just a GP”?	To some degree this is up to you. However, the general practitioner’s role in health care is crucial. They are the “gatekeepers” within the system and access to Medicare rebated specialist services is available only via appropriate GP referrals. A good quality primary care system is crucial for the population’s health. General Practice is the context in which preventive health issues can also be addressed. Aim not to be “just” a GP but a “good” GP. A good GP is invaluable – to the patient and to the health care system. Surveys have shown that the vast majority of patients rate their own GP very highly, regardless of their satisfaction with the health care system generally. Rural communities are very appreciative of their GPs.
What are the rewards of general practice?	The rewards are as variable as the individuals who choose general practice as a career. Some of the things most frequently mentioned by practicing GPs are: the challenge and variety of the day to day work, the ability to have ongoing relationships with patients and the flexibility of the career long term.
Will the training be adequate?	Australian General Practice Training ensures the quality of training through all the 17 Regional Training Providers. Depending on which qualification you are heading for at the end of training (FRACGP or FACRRM) the relevant colleges set standards for posts and supervisors and have extensive curriculum documents to guide your training. The program provided by General Practice Training – Valley to Coast facilitates attainment of the knowledge and skills required to provide optimum care to the Australian population and is delivered in a framework that responds to registrar needs. There are opportunities to gain extra skills, particularly for work in certain rural contexts and this can also be reflected in additional qualifications gained during training. The exam at the end of training is the standard for safe and unsupervised general practice. However, the emphasis of all GP education and training is on on-going and self-directed learning. As general practitioners we keep on learning and developing our skills as required by the contexts in which we work and the requirements for Continuing Professional Development (beyond basic training) reflect this.