General practice work and workforce: Interdependencies between demand, supply and quality.

Abstract

General practice is regarded as central to the Australian health system. However, issues affecting the general practitioner (GP) workforce have been focused mainly on remuneration, numbers and distribution. The focus is shifting to how best to enable GPs to deliver effective, efficient and equitable care. The aim of this paper is to identify important elements, dynamics and interdependencies that influence GPs' work and their ability to continually improve outcomes for individuals and communities. Most important problems are multifaceted and cannot be reduced to a simple, single solution. Influence diagrams capture the interdependent domains that affect general practice, such as the variations in patients' needs in the community and the impact of disadvantage and care expectations on outcomes. Identifying interrelationships between key domains should capture the dynamics that 'feed the problem'. Finding 'best possible solutions' to improve interdependent system problems and avoid the inherent risk of unintended failures requires an ongoing mix of qualitative and quantitative modelling.