Modernisation isn't about replacing what makes general practice valuable. It's about giving GPs better tools, better systems and a stronger voice.
General practice will look different in 10 years, but the real question is not whether change is coming, but whether GPs help shape it or are expected to adapt to reforms designed around us.
Healthcare is already changing and our patients are living longer with more complex needs.
Digital systems are becoming part of everyday care and artificial intelligence (AI) is beginning to change the way healthcare is delivered.
I’m optimistic about AI if used thoughtfully. It has the potential to reduce administrative burden, improve access to information and give GPs more time with patients, but technology should support clinical judgement, not replace it.
General practice doesn’t need convincing to modernise because it already is. What’s lagging is whether government policy is keeping pace with that change or continuing to hold it back.
Throughout my time as a practising GP and practice owner, I’ve watched practices embrace enormous change. New technologies, new funding models and new ways of delivering care have all become part of everyday practice. The question has never been whether GPs are willing to modernise. It’s whether reform is designed with us or around us.
Modernisation should improve patient care, not simply digitise existing processes or create new ones.
It must strengthen continuity, support clinical judgement and free GPs to spend more time with patients. Most importantly, it must keep the GP at the centre of patient care rather than become the focus of the consultation.
Change is necessary
General practice has always evolved. Gold was still a therapeutic option for rheumatoid arthritis when I was a medical student, now we have biologics and monoclonal antibodies. The profession we practice in today is not the same as the one we entered decades ago, and nor should it be.
Workforce shortages, population ageing, chronic disease, mental ill-health and rising patient expectations mean our systems must keep changing. Practices need better ways to share information, coordinate care, support teams and reduce avoidable and odious administration.
The status quo in Australian general practice is not sustainable because GPs are spending up to a third of their working week on compliance and non-patient-contact tasks, and because outdated systems make it harder for patients and clinicians to navigate care.
Reform isn’t in question anymore. What matters now is which kind we choose.
Technology should serve care
Technology can make general practice better. It can reduce duplication, improve access to information, support clinical decision-making and remove low-value administrative work.
But technology is a tool, not a model of care.
A digital platform cannot replace clinical judgement, and an algorithm cannot understand a patient’s history, family, community and changing circumstances in the way a trusted GP can. Convenience is useful, but it is not the same as quality and should not override the value of continuity and humanity in the doctor-patient relationship.
We should judge technology by whether it gives clinicians more time for care, improves safety and strengthens the relationship between patients and their GP. If technology creates more work instead of less, it isn’t solving the problem.
We’re already seeing what this looks like when it’s done well:
- Secure messaging now let’s patients contact their GP directly for repeat scripts and referrals, and receive care asynchronously, without losing the benefit of a GP who already knows them.
- A request for a repeat contraceptive pill script can become a prompt to flag an overdue cervical screening test, arrange overdue STI testing and bloodwork before the next visit, or add a note for follow-up.
The GP is remunerated for that judgement, and the patient gets convenience without losing continuity.
GP-led multidisciplinary care Is the future
Team-based care will be essential to meeting the growing needs of our communities. Nurses, pharmacists, allied health professionals, practice managers and other clinicians all bring valuable expertise, but only the expert generalist has the breadth of training and experience to oversee the clinical governance of teams managing complex, multi-condition care.
Related
The scope-of-practice case against fragmenting care has already been made in full elsewhere (see The Retailification of Healthcare, Independent Pharmacy Prescribing Is Not About a Turf War, and What Happens When Political Decisions Override Clinical Governance). The question worth asking here is narrower: what makes multidisciplinary care safe to scale as practices modernise?
That is not simply asking different professionals to work together. It’s giving them shared records and clear systems, properly funded, so a GP can stay across a patient’s care wherever they’re seen, rather than it depending on whichever provider holds the most recent note.
MyMedicare is a step in the right direction here. It formalises the relationship between a patient and their usual GP, and gives that GP clearer oversight of their team, but it only works if it’s flexible enough to reflect how patients actually live. Care doesn’t always sit inside one practice, and Aboriginal and Torres Strait Islander patients in particular often need care across more than one service. The model has to flex to that reality, not the other way around.
GP-led care doesn’t diminish other professionals’ contribution, but it does give every member of the team what they need to contribute safely which is as much a design problem as a workforce one.
The future of primary care is not less GP-led. It is more GP-led than ever.
Reform must protect clinical autonomy
I’ve represented general practice in major health system reforms before, and the lesson has been consistent: GPs must be involved from the beginning when governments design new models of care. We cannot continue to be consulted after decisions have been made and expected to absorb the consequences.
General practices understand their communities. A rural practice, an outer-suburban clinic and an inner-city service may all need to organise care differently.
Reform should give practices the flexibility to respond to those needs, not force every community into the same centrally designed model.
The recent Assignment of Benefits changes illustrates exactly why GP consultation in health policy matters and how modernising and digitising systems can create chaos rather than solve problems. When the changes were proposed, it was clear that many elderly and disabled patients would struggle with the new digital signature requirements and GPs were in real danger of either routinely falling foul of Medicare compliance or being unable to bill their patients at all.
The College worked with government to secure practical concessions that protected patients and practices while longer-term solutions are explored: a 12-month grace period, continued use of verbal patient consent during the transition, and an educative rather than punitive approach to compliance (see Good News for General Practice for the detail). That’s a genuine result and reflects the power of collaboration.
But a grace period is not a fix because the underlying model still doesn’t work for many of the patients who rely on it most, and this is exactly the kind of unintended consequence that earlier GP involvement in the design would have caught before it needed fixing after the fact.
A conversation would have determined what the problem was the new assignment rules are trying to fix, because every additional layer of regulation that makes general practice harder and more expensive to run ultimately delivers a blow to patients, not just the GPs trying to make the system somehow work.
If the intent is to rein in rogue pop-up services and the like, then by all means do that, but not at the expense of an entire sector within which the overwhelming majority are just trying to do a good job.
And before we digitise, regulate and re-design, we must be confident life gets better, not worse.
The point is that the fundamentals of GP clinical autonomy, billing autonomy and practice self-determination are not threats to a sustainable and efficient health system. They allow innovation to work locally and reflect the rights and responsibilities of highly trained medical professionals and must not be surreptitiously removed as we usher is new versions of the Australian health system.
The future should be more GP-led, not less
My vision is not to preserve general practice exactly as it is today. It is to preserve what matters while changing what no longer serves patients or the profession.
We should:
- embrace technology that reduces red tape,
- build multidisciplinary teams that expand capacity,
- use data more intelligently,
- fund modern models of care; and
- make it easier for practices to innovate.
Modernisation isn’t about replacing what makes general practice valuable. It’s about giving GPs better tools, better systems and a stronger voice so we can spend more time doing what expert generalists do: caring skillfully for patients.
That’s the future I believe general practice deserves, and the future I seek to build.
Dr Anita Muñoz is a G, former chair of the Victoria Faculty, Royal Australian College of General Practitioners, and a candidate for the presidency of the RACGP.
