Does academic general practice have a future?

rom modest beginnings little more than 30 years ago, Australian academic general practice has grown and prospered — particularly with the recent introduction of rural clinical departments and additional medical schools. General practice sits naturally at the “front line” for the prevention and management of a multitude of health problems — management that increasingly relies on the best information, gleaned from research in the primary care setting. However, our health system, like others in developed countries worldwide, is failing fast. Productivity Commission reports, parliamentary inquiries and numerous academic papers describe the current waste and lack of focus on outcomes in our health system,1-3 at a time when communities and dedicated health professionals are screaming for the resources to provide acceptable care for their communities. Academic primary care will take a key role in Australia’s health care future — developing and evaluating new care models and therapies for Australian communities, care-givers and health care professionals. New opportunities in integrated care delivery, health information technology and patient engagement in self-care will provide fertile ground for academic general practice, as will the clinical application of new technologies, medication and treatment modalities. It will be crucial to explore and understand changing societal approaches to end-of-life decision-making, personal rights and responsibilities in health, and the rationing and allocation of the shrinking health dollar. Working across sectors — within the health care system and between health, education, local government and community services — will become much more important, and primary care, supported by academic general practice, is likely to provide the crucible for many new initiatives and approaches. What will academic general practice of the future look like? • Committed to teaching — the lifeblood of our profession; • Increasingly “broad church” — encompassing clinical, health service, multidisciplinary and intersectoral research; • Increasingly essential to effective health service delivery in the “real world”; • Increasingly networked with consumers, government and professional groups, such as colleges and divisions of general practice. Sharing in creating and evaluating a “Brave New World”? — academic general practice in Australia can’t wait!