What is the effect of non-clinical change on Australian GPs? : a survey of regional and rural general practitioners

Australian General Medical Practices have undergone substantial change over the last two decades. This thesis identifies those changes and examines how a cohort of regional and rural general practitioners has responded to them. It also identifies the impact of environmental change on the GPs, their practices and their patients. The methodology is largely qualitative, based on interviews with 20 practicing GPs in the Illawarra and Shoalhaven regions of Australia. Case studies were developed with the assistance of a group of GP academics from each mainland state, meeting as an electronic Delphi group. The case studies were selected to be of relevance and importance to most GPs in order to stimulate discussion about a defined environmental change. The data were categorised using a stem-based framework supported by the software product Nvivo. Themes were identified and refined as the transcript of each interview was analysed. Themes were then categorised according to the response of the GPs’ to change and the impact of change on the GP, the general practice and the general practice patient. The findings help in understanding how a cohort of GPs have responded to changes in their environment, how government has introduced reforms, and what response can be made to benefit the longer term delivery of primary care services in Australia