Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
Shopping Cart: ( empty )
You are here: Home > Journals > PY > PY08071
RESEARCH ARTICLE
Contents Vol 15(4)

General practitioner networks matter in primary health care team service provision

Lucio Naccarella
+ Author Affiliations
- Author Affiliations

The Australian Health Workforce Institute, The University of Melbourne, 200 Berkeley St, Carlton, Vic. 3053, Australia. Email: l.naccarella@unimelb.edu.au

Australian Journal of Primary Health 15(4) 312-318 https://doi.org/10.1071/PY08071
Published: 26 November 2009

Abstract

Australia is undergoing significant primary health care policy reforms in response to concerns about quality of care, increasing burden of complex and chronic diseases, and workforce shortages. Governments are encouraging multidisciplinary teamwork between general practitioners (GP) and other primary health care service providers. Essential elements of teamwork have been addressed in policy initiatives, yet important dimensions of the way GP develop and use their work-related relationships in their practice remain unrecognised. This paper draws upon a doctoral thesis that explored the types and the qualities of GP work-related relationships. A qualitative research methodology combined with a relational perspective was used. Data were collected from a pilot, main and a validation study. Fifty interviews were conducted, including: GP, clinic staff, service providers, support organisation personnel and policymakers. A complex web of interdependent work-related relationships exist between GP and other health care providers. Four main types of GP work-related relationships emerged: clinical problem solving, obtaining metaknowledge, obtaining legitimisation, and validation. Key qualities of GP work-related relationships included the nominated providers’ competence, accessibility, goodwill, honesty, consistency and communication styles. A validation study verified research findings. The research provides evidence that the nature of GP work-related relationships have implications for other practitioners who need to work with GP. The findings challenge the current primary health care policy emphasis on using structural reforms such as prescribed service delivery processes and financial incentives to encourage teamwork.

Additional keywords: general practice, multidisciplinary teamwork, primary care, relationships.


Acknowledgements

The research reported in this paper was part of a doctoral thesis supported by a NHMRC Postgraduate Primary Health Care Scholarship. I acknowledge the continual support of my three supervisors, Dr Jane Sims, Professor Pip Pattison and Associate Professor Rae Walker.


References


Australian General Practice Network (2007) ‘Funding general practice-based multidisciplinary team care in Australia: improving outcomes and reducing inequality in health – a discussion paper.’ Available at http://www.agpn.com.au/site/content.cfm?page_id=34378&current_category_code=106&leca=16 [Verified September 2006]

COAG (2006) ‘COAG response to the productivity commission report on Australia’s health workforce.’ Available at http://www.coag.gov.au/coag_meeting_outcomes/2006-07-14/docs/attachment_a_response_pc_health_workforce.rtf [Verified July 2009]

Commonwealth Department of Health and Ageing (2005) ‘Enhanced primary care program.’ Available at http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health--caseconf.htm [Verified September 2005]

Commonwealth of Australia (2005) ‘Australia’s health workforce.’ Research report. Available at http://www.pc.gov.au/study/healthworkforce/finalreport/healthworkforce.pdf [Verified September 2005]

Commonwealth of Australia (2008a) ‘Towards a national primary health care strategy: a discussion paper from the Australian Government.’ Available at http://www.health.gov.au/primaryhealthstrategy [Verified October 2008]

Commonwealth of Australia (2008b) ‘Enhanced Primary Care Program (EPCP): Chronic Disease Management (CDM) Medicare items.’ Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/pcd-programs--chronicdisease.htm [Verified September 2008]

Delva D, Jamieson M, Lemieux M (2008) Team effectiveness in academic primary health care teams. Journal of Interprofessional Care 22(6), 598–611.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [Verified September 2006]

Mickan S (2005) Evaluating the effectiveness of health care teams. Australian Health Review 29(2), 211–217.
| PubMed | [Verified September 2007]

Qualitative Solutions and Research (1991) ‘QSR NU*IST. User guide.’ (Qualitative Solutions and Research: Melbourne)

Royal Australian College of General Practitioners (2005) ‘GPs and general practice teams (DRAFT) RACGP position statement.’ Available at http://www.racgp.org.au/Content/NavigationMenu/Advocacy/IssuesinGeneralPractice/GPworkforceandfundingissues1/Teamsinourgeneralpractices/20060829GPTeams.pdf [Verified September 2005]

Royal College of General Practitioners (2007) ‘The primary care practice and its team. RCGP information sheet.’ Available at http://www.rcgp.org.uk/PDF/ISS_INFO_21_FEB07.pdf [Verified March 2007]

Scott J, Tallia A, Crosson JC, Orzano AJ, Stroebel C , et al . (2005) Social network analysis as an analytical tool for interaction patterns in primary care practice. Annals of Family Medicine 3, 443–448.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [Verified September 2006]

Strauss A , Corbin J (1998) ‘Basics of qualitative research: techniques and procedures for developing grounded theory.’ 2nd edn. (Sage: Thousand Oaks, CA)

Wasserman S , Faust K (1994) ‘Social network analysis: methods and applications.’ (Cambridge University Press)