Fears clinical indicators will compromise care

THE RACGP will face a massive task to convince grassroots GPs of the value of clinical indicators, according to an MO poll, with just 17% of GPs stating they believe the use of such indicators will lead to improvements in patient care.

As part of the fourth review of the Standards for General Practices, the RACGP is surveying GPs on whether clinical indicators should be linked to practice accreditation for the first time.

However, in a poll conducted for MO by Cegedim Strategic Data, only 14% of GPs agreed that clinical indicators should be used for this purpose. Most were sceptical of their use, and 83% of GPs voiced fears that the clinical indicators chosen would require a degree of patient compliance to be met.

Nearly three-quarters were concerned that introducing clinical indicators would create additional demands on staff time, 67% believed it would lead to greater accreditation costs, and 61% did not believe their practice management system would be able to collect the necessary data.

Dr Rod Pearce, chair of the AMA council of general practice, held concerns that the introduction of clinical indicators into practice accreditation would also have a detrimental impact on the doctor-patient relationship.

“GPs start to worry about having this box ticked, rather than saying ‘For this patient, something else is more important today’,” he said. “Should the consultation be driven by what patients need or what accreditation requires?”

Alistair Vickery, professor of general practice at the University of Western Australia, agreed.

“[Doctors] are worried... because they think it will interfere with the clinical care by fundamentally changing the way a GP approaches a patient.”

Dr Lynton Hudson, chair of the RACGP national expert committee on standards for general practices, said he understood doctors’ misgivings, but maintained clinical indicators had an important role in helping GPs to improve patient care.

“When a patient is sitting in the room, it is not about indicators or statistics,” he said. “But by looking at the clinical indicators across the whole practice, you can see what needs to be better provided.” 

The RACGP survey will close on 30 November, and the college plans to release a draft of its standards by February next year. The draft will be trialled and, if successful, introduced by 1 October 2010.

Will clinical indicators lead to improved care?

No: 50%
Possibly: 34%
Yes: 17%