Physician in practice clinic: educating GPs in endocrinology through specialist-outreach

Moffatt, J., Hossain, D. and Hansford, G. (2012) Physician in practice clinic: educating GPs in endocrinology through specialist-outreach. Rural & Remote Health, 12 4: 2265.1-2265.14.

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Author Moffatt, J.
Hossain, D.
Hansford, G.
Title Physician in practice clinic: educating GPs in endocrinology through specialist-outreach
Journal name Rural & Remote Health   Check publisher's open access policy
ISSN 1445-6354
Publication date 2012-12-03
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 12
Issue 4
Start page 2265.1
End page 2265.14
Total pages 14
Place of publication Deakin West, ACT, Australia
Publisher Australian Rural Health Education Network
Language eng
Formatted abstract
Introduction: The escalation in the incidence of diabetes mellitus type 2 requires innovative approaches to manage the increasing burden of service provision, a particularly challenging issue for rural communities. Whereas shared care through specialist outreach clinics is a traditional approach to the management of chronic disease, the results on effectiveness are mixed. Where there is a joint consultation with both the General Practitioner (GP) and specialist present during the patient  consultation, benefits are reported; however, this model of specialist outreach is uncommon when compared with the more typical model where a specialist sees the patient alone but at the GP’s rooms, and later communicates with the GP. The explicit long-term goal of the Physician in Practice Clinic, which emulates the joint consultation model, is improved patient outcomes through better educated and more confident GPs, easier service access for patients and reduced waiting lists. The education of GPs in endocrinology, an early goal, is the focus of the article.
Methods: Fifteen GPs were sampled purposively on sex, rural/regional location, place of training, practice size and length of time practising locally. Semi-structured interviews were conducted, transcribed then thematically analysed.
Results: General practitioners reported substantial educational benefits. One aspect is the face-to-face contact with the endocrinologist which promotes an interactive learning process. All GPs reported that they acquired new knowledge. An important aspect of this new knowledge is that it could be used quickly, often immediately, and also used in the longer term when generalised for use with other patients. A follow-on effect from the new knowledge and its short- and long-term application was an increase inprofessional confidence. A benefit with the potential for a long-term effect was improved relationships between the GPs and specialist, and the GPs reporting that they were making fewer referrals. The greatest benefits reported by those in small practices were the interactive learning and being able to generalise the new knowledge to other patients. For rural doctors most benefit was from the interactive  learning, whereas for regional doctors it was increased confidence. Australian trained doctors reported mostly the benefits of being able to use the knowledge quickly and the interactive learning. By contrast, doctors not trained in Australia favoured the increased confidence and the generalisability of the new knowledge. Those who had practised locally for up to 10 years benefited most from the new knowledge and the increased confidence, and females benefited most from increased confidence and receiving new knowledge.
Conclusions: From the GPs’ perspective, the goal of creating better educated and  more confident GPs in endocrinology in this rural/regional setting was achieved. Therefore this easily replicated but novel approach to specialist outreach has the potential to improve health outcomes in chronic disease in rural communities. In addition, a more tailored approach to shaping the Clinics based on the socio-demographic categories reported here could have additional short- and long-term  benefits.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number 2265

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 17 Apr 2013, 20:24:33 EST by Erin Bowly on behalf of Rural Clinical School