We’re doing okay, says leading general practice advocate. Don’t let the naysayers tell you otherwise.
When push comes to shove, and the digital health specialists are talking transformation and change management, it’s important for GPs to remember one key thing, says former RACGP president and current national chair of the AMA’s Council of General Practice, Dr Karen Price.
“First of all,” she said, “we’re actually doing okay.
“We’ve all got our own ideas, and unless we coalesce those and talk together, it’s going to be hard to meet that top-down, bottom-up approach that’s so necessary to run the system, but we’re still doing all right.”
Dr Price was speaking at HSD’s Towards One Healthcare System summit held in Canberra earlier this week, where the focus was on connected care and the digital transformation of Australia’s health systems.
“Let’s talk about iterations of quality improvement, rather than thinking that everything has to be upended for the sake of one system,” said Dr Price, who was president of the RACGP through the covid pandemic, and is most famous for telling GPs to move to mixed billing if the alternative was closing their doors.
“I don’t think health systems should become an IT system,” she told delegates.
“That’s a real danger, and I think we’ve got to understand that the philosophy of healthcare in the community is very different to the philosophy of healthcare in the hospital, and the requirements of patients must come first.”
Dr Price said the strength of the healthcare system, from allied health to hospital-based specialists to community-based providers, was the ability to “fill the gaps” where needed for their specific situations.
“We have that local adaptive intelligence to fill the gap, and that’s what we do,” she said.
“We need the system not to constrain that local adaptive intelligence, to have autonomy within that, not compliance and regulation that makes us go down a linear way, because the patient is not a linear box. The patient is complex. Their needs are complex.”
The concept of “one healthcare system” was not a new one, Dr Price said.
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“We had it. Thirty years ago, GPs were in hospitals. GPs followed their patients. GPs did home visits. They were doing procedures.
“I did procedures. I had a radiology licence. We did all our own x-rays.
“All of that’s been relatively defunded, and we were kicked out of the hospitals and local community hospitals … because apparently we weren’t following the evidence.
“Evidence is a guideline. Professor David Sackett of the European Working Group on evidence-based medicine said, ‘don’t let them be used as a tyranny’,” said Dr Price.
“The evidence base … is important, but it also needs local adaptive intelligence, again, to apply to the particular patient. In the case of multimorbidity, that’s not possible. It’s very difficult to apply evidence for one disease across when you have multiple diseases which might communicate with each other.
“Those philosophy issues and the theoretical issues are not being attended to.
“We’re so far down in the weeds of our own worlds and ecosystems that we forget this. We are all part of the system.”
Dr Price said despite all the changes both real and mooted, not a lot had changed about the way GPs worked.
“Everyone wants to make their work meaningful,” she said.
“Politicians want votes, and the way that we see value is very different, and I think we’ve got to align that.
“Do I think it will change? I think it will change slowly, like it did when I instituted computerisation back in my own practice in the early 1990s.
“It’s changed things, but the patients haven’t changed. The conditions haven’t changed. The way that I interact with the patient hasn’t changed.
“I’ve got to do more paperwork, I’ve got to do more computer work, I’ve got to do more keystrokes now to satisfy payment models.
“But the patients and the way I interact with them, the way that I’ve trained, is not very different to what I did 35 years ago, not at all.”
The Towards One Healthcare System summit was held in Canberra on Tuesday 17 June and Wednesday 18 June 2025.