General practitioner involvement in non-procedural medicine in public hospitals in Melbourne, Australia

This study is a survey of general practitioners practising in an area in Melbourne, Australia, where there are two medium sized public hospitals with limited general practitioner admitting rights. A questionnaire was mailed to the 207 general practitioners practising in the study area; 167 (81%) responded. Seventy one per cent of respondents had public hospital admitting rights and 73% aimed to manage as many medical patients in hospital as possible. The main reasons given for such involvement were patient expectation, professional satisfaction and the benefits to patients, beyond that of reassurance, which followed from continuity of care. About half of respondents (52%) agreed that their role was a liaison or coordinating one alongside hospital specialists. Fifty-four per cent of respondents overall had in fact managed at least two medical patients in public hospitals in the past 12 months. Lack of availability of general practitioner beds and specialist dominance in public hospitals rather than inadequate time or remuneration were perceived to be the main barriers to hospital practice. Almost three-quarters of respondents (72%) believed general practitioners would be excluded from public hospitals in the foreseeable future. They blamed specialist dominance and general practitioner apathy equally for this predicted state of affairs. A debate on the desirability or otherwise of such an exclusion is overdue within the medical community in order to consider what will otherwise be a fait accompli.