11 December 2019

It was a quiet year…until…

CPD Education General Practice

Hard to believe another year is over. I know it makes me sound like I’m 103, but time does seem to be speeding up, doesn’t it?

On reflection, 2019 has been a relatively quiet year for general practice. We’ve had measles outbreaks and another flu season but nothing of epidemic proportions. We’ve had no major new ground-breaking GP drugs and fortunately no major drug recalls – except maybe Zantac.

Voluntary assisted dying is now available in Victoria but uptake is slow and so far there appears to have been minimal impact on general practice. Mental health, heart disease, respiratory illnesses and diabetes still tend to occupy the vast majority of our working days. Aged care has certainly hit the headlines in the general media, but to date very little appears to have changed on the ground, particularly in the aged care facilities I visit.

We have had a federal election, again with little change to the status quo. We even kept the same federal health minister.

As for the business of general practice, we have gratefully received the meagre benefits of the continued thawing of the Medicare freeze. I doubt any of us are now moving into a major new tax bracket as a consequence of the rebate rise, but it has to be better than nothing.

Even the GP colleges feel like they have been relatively quiet this year. Despite the exit of one long-standing and at times, controversial CEO, the RACGP has not seemed to have created any major waves – even choosing to keep the CPD requirements for the next three years much the same as this triennium. While ACRRM continues its solid and worthwhile championing of rural medicine with all the ongoing challenges that involves.

Yep – a quiet year…

And then the Medical Board of Australia throws a curve ball.

Last month, our overarching authoritative body released its proposed revised CPD Registration standard which appears to create yet another major bureaucratic burden for the busy GP just trying to do their job.

You will have seen the board’s proposed CPD  requirements. Fifty hours annually, with at least a quarter of this allocated to measuring outcomes (and isn’t that easy in GP land?), another quarter to be dedicated to review performance and at least another quarter on educational activities.

Don’t you get that sinking feeling in your stomach when you read this? That feeling we are just like mice on those little wheels, running faster and faster to stay on the same spot.

I know I sound like I’m always critical of any authoritative body. I don’t mean to be. I am absolutely committed to ongoing medical education and the need for all doctors to stay up-to-date. I also firmly believe in the regulation of standards. But, seriously, 50 hours a year? That’s more than a full-time working week. And it is such a prescriptive breakdown of the nature of the CPD that needs to be undertaken.

None of the activities proposed are completely without merit, but the proposal just reeks of academic musing doesn’t it? Who decided 50 was the magic number?

Tellingly, the information says the proposed changes are “evidence-directed” as opposed to “evidence-based”. I’ve yet to see the research that definitively shows these CPD changes will result in a higher standard of general practice.  Do you think any of the people who drafted these changes have actually worked in a busy general practice? I wonder.

Of course, it may not be the major burden it seems to be. As the board states in its media release: “We are not proposing fundamentally new processes through this revised standard. Rather, our goal is to extract more value from existing CPD programs and encourage development and innovation.”

But 50 hours?! And apparently they want all doctors to start the year with a plan of what they want to learn over the course of the year, what they particularly want to cover in their professional development.

As the RACGP’s experiment with the PLAN activity showed, for truly general general practitioners it is very hard to predict which areas of medicine should be the focus for education. The remit is, by definition, so broad.

I’m sure I’m not alone when I say experience has been my greatest educator. There is nothing like having to manage a patient with a complicated or rare condition to have you checking up-to-date or therapeutic guidelines.

As GPs we are always learning. We have to be. I totally recognise the need to ensure a standard of continuing professional development is maintained, but why make it so onerous and so bureaucratic?  It just doesn’t make sense. Why create another set of hoops for GPs to jump through when morale in the specialty is already low and the GP colleges are struggling to fill the available training positions?

GPs should feel supported by CPD, not punished.

One spark of hope is the fact this is a draft proposal. We have until February 14 next year to make a submission voicing our concerns, criticisms or critiques on the proposed changes. We can’t just whinge from the sidelines. We have an opportunity to have input into this decision, even if it is just to suggest some caveats to the proposed CPD requirements.

Here is the link to the draft proposal and the way to make your submission: https://www.medicalboard.gov.au/News/Current-Consultations.aspx

Let’s have our say and then we can all just relax and go back to enjoying our relatively uneventful year.

Hope you have a lovely Christmas and New Year and we look forward to getting back in touch in 2020. Take care.