Preventive care in general practice in Australia: a public health perspective

There is considerable potential in Australia for implementing effective preventive care strategies in the general practice setting, especially in the context of Australia's new health goals and targets towards the year 2000. There is a clear need for the clinical paradigm, which focuses on developing efficacious, intensive, practitioner-delivered lifestyle change interventions, to be integrated within a broader public health approach. However, while there has been considerable growth in the breath and variety of health promotion research and activity being carried out in general practice in Australia, the evidence supportive of the efficacy and effectiveness of physician-based interventions (except in the case of smoking cessation) has been less than compelling, and a number of problems still remain. These include: health promotion still remains a minor component of the great majority of consultations; there are many potential interventions which are possible, but little evidence that they will be used appropriately; there is little evidence that patients who are most in need are receiving appropriate services; there is generally a poor linkage between research and practice; and there are real doubts about the ability of the system to sustain preventive care in general practice.