Is it time to include the practice nurse in integrated primary health care?

Background: The new '700 series' Medical Benefit Schedule (MBS) items for general practice introduce greatly increased potential for collaboration between general practitioners and other health professionals in patient care. Aim: To investigate the current perceptions of Australian GPs with respect to the desirability and impact of 'sharing care' with nurses and other health professionals. Method: Survey of a sample of GPs in Queensland and NSW participating in the Department of Veterans' Affairs Preventive Care Trial. Results: Fifty-two percent of GPs surveyed worked in a practice where a nurse was employed. The main role of the practice nurse was to do electrocardiograms, apply dressings, and triage duties. Practice nurses played only a minor role in health promotion and education. Seventy percent of GPs identified 'cost' and 58% 'lack of a Medicare item' as the major disincentives to the employment of a practice nurse. Seventy percent of GPs were satisfied with the level of communication with community based health professionals outside the practice, with 'time' nominated as the greatest barrier to optimal contact. Eighty-two percent of GPs considered other health professionals had a role in conducting preventive home visits for the older population, with 70% of GPs identifying that these health professionals had the potential to identify additional health problems, previously unaddressed. Conclusion: Study findings demonstrate an acceptance by GPs of the nurses role and other health professionals in integrated patient care. Funding is seen as the major impediment to the greater utilisation of practice nurses in the general practice setting