Looming changes to continuing professional development are leaving some GPs feeling patronised, questioning the evidence behind it and viewing it as another overreach by government.
The CPD reform, which is the brainchild of AHPRA and the National Boards and was recently embraced by the RACGP, would see all registered doctors completing similar activities regardless of their specialty from January 2023.
Dr Umair Masood, vice president of grassroots advocacy organisation the Australian Society of General Practice, told TMR the new framework ignored the needs of GPs and the unique nature of their specialty.
“If something isn’t broken, why fix it?” he said. “GPs have a very broad range of scope, unlike other specialists, so each GP has different requirements that they might need to look at and address – the [current] activity system works very well in that respect.”
Under ACRRM’s CPD triennium, doctors complete an equal share of educational activities, performance review and outcome measurements equivalent to 150 hours.
GPs with the RACGP must complete a minimum of 130 activity points each triennium, some of which can be self-directed learning.
“If you’ve got a knowledge gap, let’s say in skin cancer, you can go and look at activities on skin cancer and you would get the training that’s required,” Dr Masood said.
There are three main changes to how CPD will operate from January 2023.
The first is the introduction of CPD homes, which means all doctors will have to have their learning monitored by one accredited organisation. For most GPs, this will be the RACGP or ACRRM, but they could move to another organisation if it was accredited by the Australian Medical Council as a CPD home.
Doctors will also have to make an annual professional development plan (PDP) showing targeted learning goals to strengthen their practice.
And they will have to show they are improving the value of their professional development, with half of the 50 required hours per year spent reviewing outcomes and measuring performance.
Several GPs have told TMR they would like the see the evidence for the benefit of that activity.
“At the end of the day, is this going to make us better GPs?” Dr Masood said.
“Where’s the evidence for that? We haven’t seen the evidence that the changes will make us better doctors or make our practice safer.”
There are also questions about how “self-reflection” is supposed to add value to clinical practice.
“The vast majority of GPs that I speak to are all against the idea,” Dr Masood said.
And given that the profession is currently awash with negative feedback about the CPD reforms, GPs have been confused by the RACGP’s positive response – but Dr Masood suggests this may be a strategic move to counter competition from startup CPD homes.
Last month, shortly after the framework won ministerial approval, RACGP president Dr Karen Price told TMR that the RACGP was pleased to have finally been given the green light concerning the changes.
“They hold no surprises, and the RACGP is planning for a seamless integration of the new requirements in 2023,” she said.
Dr Price also said there had been a long lead time and consultation phase stretching back to 2016 for the proposed CPD framework.
Given the approval of the MBA’s CPD framework comes just months after the legislative change that allowed GPs to exit their college membership without risking their specialist registration status, Dr Masood said it may be strategic for the college to get on board with the changes as soon as possible – and become the first “home” to neatly deliver the new CPD framework to its members.
“I think the new requirements that are being put forward may suit the RACGP to better to hang on to their membership base so they can provide the new CPD requirements [to members],” he said.
“If new CPD homes come into being, are they going to be able to handle the current requirements? And what exactly are the requirements?
“The details have not been released, so I think it’s going to make it very difficult for other providers to actually get into the market.”
But regardless, it comes less than three years after the RACGP spent time and money developing a new CPD program for its members.
And it’s clear that since that time, the RACGP has had a change of heart about adopting the MBA’s new CPD principles.
At the end of 2019, the late RACGP President Dr Harry Nespolon told TMR it was hard to see how the college could adopt the principles set out by the MBA without redesigning the relatively new CPD program that had just launched.
“Our CPD is all about education rather than paperwork,” he told TMR at the time.
“I’m not sure how I’m learning new knowledge by doing outcomes measurement.”
At the very least, Dr Nespolon said he hoped practices participating in the quality improvement PIP would be able to satisfy the MBA’s requirement for spending 12.5 hours measuring outcomes, without having to do additional activities.
You can hear more of this conversation in the next episode of The Tea Room, out Monday