Aust Fam Physician
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The Aboriginal and Torres Strait Islander life expectancy gap is associated with lower primary care usage by Indigenous Australians. Many Indigenous Australians regard private general practitioners as their usual source of healthcare. However, a range of barriers results in relatively low access to primary care, with subsequent inadequate prevention and management of chronic disease. Indigenous primary care requires development of a set of attributes by the GP. Clinician autonomy may need to be tempered to be responsive to the needs of local indigenous communities. ⋯ Over a period of 1 year, registered indigenous patients at the private general practice clinic increased from 10 to 147; monthly attendance increased from five to 40 (p<0.001). Local engagement between private practices and indigenous communities may be implemented widely to reduce the primary care gap.
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A general practice in inner city Melbourne (Victoria), committed to ensuring quality standards of clinical care, developed a process for peer review of their doctors' performance. The aim was to ensure that there was a robust and fair process for evaluation of doctor performance from both a safety point of view, and from the perspective of contribution to team based practice. ⋯ From the springboard of weekly clinical meetings which address critical incidents and near misses, the practice doctors developed an annual process of formal performance review incorporating hard and soft indicators of clinical performance and compliance with professional and practice standards. This type of activity falls within the scope of quality improvement in general practice.
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Only 36% of sick Australians report being able to get an appointment on the day they need it, which is poor by international standards. This delay in care may impact on practice team morale, practice profitability and patient care. The Australian Primary Care Collaboratives Program aims to find better ways to provide primary healthcare services to patients through shared learning, peer support, training, education and support systems. ⋯ Demand for appointments is finite, predictable and can be shaped. Delay is waste and the enemy of good healthcare. Where delay can be eliminated it should be. By measuring practice demand and capacity, improvements can be designed which will result in reduction in measured delay and patient unmet needs, and increased patient satisfaction.
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This article forms part of our 'Paperwork' series for 2011, providing information about a range of paperwork that general practitioners complete regularly. The aim of the series is to provide information on the purpose of the paperwork, and hints on how to complete it accurately. This will allow the GP to be more efficient and the patient to have an accurately completed piece of paperwork for the purpose required. ⋯ Medical boards receive numerous complaints each year from patients, employers, insurers and other parties about the quality and accuracy of sickness certificates. General practitioners who deliberately issue a false, misleading or inaccurate certificate could face disciplinary action, or even a charge of fraud. This article provides some guidance for GPs about writing certificates certifying illness, and discusses common medicolegal issues associated with sickness certificates.