Health Care Homes and whole-person care: A qualitative study of general practitioners' views.

Abstract

Commitment to providing whole-person care (WPC) is a core value of general practice. The current Health Care Homes (HCHs) trial reforms Australian primary care with the aim of improving complex and chronic disease care. The aim of this study was to clarify how Australian general practitioners (GPs) anticipate the government's HCHs will affect WPC. Qualitative semi-structured interviews with 20 Australian GPs and general practice registrars were conducted between May and November 2018. GPs supported the principles underlying the Medical Home concept, believing these could assist WPC by facilitating flexibility, continuity and scope of care and team involvement. However, many had serious misgivings about the government's HCH trial, believing that aspects of capitation funding and limitation of the trial to chronic disease management may impede WPC. They also reported practical struggles with the trial. GPs anticipate a mixed impact of HCHs on WPC and potentially on the therapeutic relationship underlying WPC. They identified practical struggles previous literature anticipated. These findings provide on-the-ground evidence of GPs' views about HCHs and WPC, which stakeholders planning the ongoing direction of Australian primary care should carefully consider.