Concerningly, there was only $5 million earmarked for primary care research this year in the near $400 million Medical Research Future Fund
If we don’t invest in general practice research, the future health of Australians is at risk, experts say.
The specialty is complex and ever-evolving, and right now GPs need to be across 167 health problems to cover 85% of the most frequently seen conditions. The population is also ageing, multimorbidity is the new normal and healthcare is becoming increasingly community-based.
Yet funding for research, which is key to building a solid evidence base, is consistently low, says Associate Professor Jo-Anne Manski-Nankervis, from the University of Melbourne.
For example, there was only $5 million earmarked for primary care in the near $400 million Medical Research Future Fund for this year.
That is a “drop in the ocean” compared with some of the fund’s other categories, says Professor Manski-Nankervis. Not to mention that the umbrella of “primary care’ also covers allied health, which itself deserves adequate funding.
In a recent perspective article for the MJA, Professor Manski-Nankervis and colleagues called on policymakers to recognise and invest in the academic side of general practice.
“We’ve got a medical specialty that provides care to the majority of Australians, and if you believe that is important, then you need to invest in the development of that specialty,” she says.
Two million Aussies visit their GP each week, and their best health outcomes hinge on a GP workforce that has quality, tailored, evidence-based information available. The problem is that research has historically been undervalued.
“A lot of what happens in general practice is unseen,” says Professor Manski-Nankervis. “It’s the hospitalisations that are prevented. It’s the person with mild or moderate depression who has that managed and treated in consultation with their GP, who can keep working.
“Just because they are not necessarily trialling a new drug or developing a new technology, it doesn’t mean our research is not as important.”
So far general practice research has led to vital insights, such as the role of daily aspirin in mortality among healthy older Australians, the comparative safety of non-sterile gloves and how to assess self-reported experiences of abuse.
Having GPs at the helm of research ensures that the context is there to ask the right questions and gear the studies to practical and translatable findings, says Professor Manski-Nankervis.
Yet it is common for GPs to be absent from research, or only included at a later stage.
Professor Manski-Nankervis says the time is right to build a strong research workforce.
Analysing big datasets, such as those held by PHNs or NPS MedicineInsight, could yield valuable insights.
“There seems to be a real vision from some of our professional colleges and organisations to really try to drive the mantle of general practice forward,” she says. For example, vocational training will soon be under the purview of ACRRM and the RACGP.
Capitalising on this opportunity also means investing in pathways for GPs seeking success as an academic practitioner.
This means being able to do a PhD, run a research program and work with colleagues to undertake research in clinical practice, and to have this time protected, she says.
The current research workforce is ageing, and younger academic GPs fear their career pathways are insecure. A question inevitably arises: will they be replaced?
