A proposal to strip away the mystery surrounding GPs qualifications makes sense, doesn't it?
Darwin GP and training supervisor Dr Sam Heard is in talks with the Medical Board on a proposal to strip away the mystery surrounding doctors’ qualifications.
The medical director of the Palmerston Super Clinic admits he met opposition when he first introduced a practice policy of informing patients whether individual doctors were qualified specialist GPs or GP registrars, and which GP was supervising each registrar.
“The CEO was against it. They thought being transparent about it would kill our business,” Dr Heard said. “But the opposite has happened. We increased our business.”
In a strong teaching practice, with six RACGP fellows and 18 registrars, Dr Heard said the system he adopted 18 months ago had proven to be empowering for patients and helpful for junior doctors.
“Patients bring things to the attention of the supervisor, but also I think the registrars feel much more willing and able to ask for help. We supervise heavily, we are very involved, and there is a lot of peer interaction.
“All doctors except specialists are supervised – and I think all of them should have on their door or their name tag the name of their supervisor, and when they make a referral they should say who their supervisor is.”
Being open about medical qualifications – as occurs in hospitals – is Dr Heard’s solution to a sensitive problem arising from Darwin’s status as an area of need, which means overseas-trained doctors not necessarily schooled in primary care can work as GPs.
“There are consequences to having doctors who are not trained in general practice working in primary care. The main negative one, from our point of view, is that there are way too many referrals, particularly in women’s health,” he said.
“In our environment, where the majority of doctors in Darwin are area-of-need doctors – and some are getting their fellowships now because they have passed the exams – people are wary about who they see.”
When patients complained about experiences with overseas-trained doctors, “the people who suffer most are the quality doctors who have their fellowship but who don’t have an Australian accent or don’t look European”.
If the public was given a cue that their doctor had qualified to the highest standard of fellowship, such problems could be to rest.
Under area-of-need rules, all doctors working as GPs need to be on “pathways” towards fellowship of the RACGP or ACRRM, but not all actually succeed in reaching that goal within the recommended four years.
A review conducted last year by the Northern Territory government noted concerns that some area-of-need practitioners were “not progressing to full registration in reasonable timeframes”.
The Board is understood to be interested in considering Dr Heard’s views.
However, it remains a mystery how many doctors would be affected by a regime of greater transparency around qualifications.
Asked to reveal the number of doctors who are fully qualified fellows of the RACGP, the college declines to say. The question is “sensitive”.
Dr Heard said he had nothing but positive feedback from colleagues, but he understood there may be tensions over any perceived slight against foreign-born doctors or fears about an impact on business models.
“I am not someone who is against overseas-trained doctors. What I am against is that training and specialism in general practice is invisible.”
