Attitudes and barriers to involvement in palliative care by Australian urban general practitioners

Despite being ideally placed to provide care to patients with terminal illness, many general practitioners (GPs) are not involved in palliative care. This study aimed to determine the level of participation of Australian urban GPs in palliative care, and to determine the main barriers facing them in providing this care.

Cross-sectional postal survey.

Between March and May 2007 a random sample of 500 GPs from southwestern and northern regions of Sydney were surveyed.

Involvement in palliative care; personal and professional characteristics of the GPs related to the provision of palliative care; GPs' views on barriers to their involvement in palliative care; GPs' confidence levels across different issues in palliative medicine.

Response rate was 61% and of these 25% of GPs were not involved in palliative care. GPs not providing palliative care were more likely to be younger, have less GP experience, work less hours, be an employee rather than a practice owner, and educated overseas. Main barriers to GPs' involvement in palliative care were lack of interest and knowledge, home visits, problems with after-hours care due to family and personal commitments. GPs felt least confident about psychosocial problems and technical aspects of palliative medicine.

About one quarter of GPs surveyed are not involved in palliative care. Strategies to increase GPs' involvement should aim at increasing their knowledge and interest in palliative care. Innovations in service provider models are required to overcome the barriers to provision of after-hours care.