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President’s Blog: The future of primary care
Friday August 9, 2024
Last weekend, I attended AMA’s National Conference in the Gold Coast. It was a great opportunity to connect in-person with State, Territory and Federal leaders of the AMA family. The elephant in the room – our recent falling out with our Federal counterpart – virtually disappeared in the collegiate, cordial environment that inevitably forms when people of common backgrounds and interests get together to discuss the big issues facing all of us across medicine, and how we can jointly tackle them. Getting back to business is critical for rebuilding the relationship between our associations, because it reminds us of why the relationship is so important.
An overarching theme of many sessions and conversations was the future mode of delivery of healthcare, particularly primary care. The community that licenses us to operate is demanding greater convenience. Families are working harder than ever, and people can see the benefits that new technology-enabled ways of engaging with services can bring to their ability to fit it all in. Coupled with this, non-medical health professions are pushing for increased scopes of practice, which can manifest as cherry-picking particular services that are perceived as straightforward and carrying little risk (for example, antibiotic prescribing for symptoms of urinary tract infection in pharmacies).
We all know that the result of some of these “advances” is fragmentation and reduction in the quality of care. We can all understand that argument when we complain to one another at meetings and in online forums. The challenge is in convincing the community, governments and politicians that they should regard traditional, mainstream medical care as superior. Is that really possible? When most patients who have presented to a pharmacy for UTI symptoms or renewed a prescription from an online provider perceived their experience as positive, how do we convince them that they have in fact been put at risk of harm as a result of fragmentation of care? Could that be perceived as medical gaslighting?
None of this means we should stop striving for continuity and excellence of care. The threat to good quality primary care is not the medical profession dropping its standards, but the myriad of convenient non-medical and non-traditional options that are highly acceptable to patients becoming the default mode of care.
