A horizontal image of a young male doctor sitting chatting to his patient. They are in a typically British doctor's practice chatting together, while he shows his patient her test results on the digital tablet.
In 2025, the Royal Australian College of General Practitioners (RACGP) Health of the Nation report once again underscores preventive care as a fundamental pillar of Australian general practice. This emphasis on prevention comes amid a debate sparked earlier this year by a paper published in the British Medical Journal (BMJ), which argued that the current demands on general practitioners (GPs) necessitate a focus on acute care rather than preventive measures such as prescribing statins.
The BMJ article, with its catchy title and attention-grabbing diagram, quickly gained traction within the GP and public health communities. It questioned whether, given the strain on the healthcare system from chronic disease growth, GPs should divert their focus away from prevention. The RACGP Specific Interests Public Health channels responded with a resounding critique, questioning whether the authors were suggesting that GPs abandon preventive efforts and instead concentrate solely on treating acute conditions.
The Importance of Preventive Care in General Practice
For public health-oriented GPs, the notion of sidelining preventive care is not only impractical but also a misunderstanding of its intrinsic value. GPs are indeed under significant time and resource pressures, but reducing preventive efforts is not the solution. Evidence consistently shows that GPs excel in delivering preventive care activities.
Having an established relationship with a primary care provider is associated with increased uptake of preventive health measures. For instance, the majority of childhood vaccinations in Australia are administered through general practice, alongside cervical screening and cardiovascular risk assessments. Behavioral interventions in primary care settings have been shown to reduce smoking rates and improve physical activity, highlighting the effectiveness of preventive measures.
The Role of Trust and Longitudinal Relationships
Preventive care is deeply intertwined with the trust and continuity inherent in the GP-patient relationship. Rarely do patients schedule appointments to discuss preventive measures, yet GPs must seize opportunities during acute care visits to address overall health. This holistic approach is vital for treating the whole person.
For example, addressing a patient’s acute gastroesophageal reflux without discussing weight reduction and alcohol intake overlooks preventive opportunities that could reduce future cardiovascular risks. Similarly, recommending travel vaccines when a patient mentions an upcoming trip, even during a routine prescription renewal, exemplifies the proactive role GPs play in preventive care.
Integrating Prevention into Practice
The question is not whether prevention should be part of general practice, but how to integrate it effectively. Literature on systematic integration of preventive health in general practice suggests that acknowledging the time and skills required, along with access to allied health services, would be beneficial starting points.
According to the Health of the Nation report, 99% of GPs offer preventive services, and 84% of respondents expressed a desire to offer more.
This data reflects the belief that prevention is inseparable from general practice and should be a source of pride and professional satisfaction. The adage that it is more effective to place a fence at the edge of a cliff than to add ambulances at the bottom aptly captures the essence of preventive care.
Looking Forward: The Future of Preventive Care
As the healthcare landscape continues to evolve, the integration of preventive care into general practice remains crucial. The ongoing dialogue about the balance between acute and preventive care highlights the need for systemic support and resources to empower GPs in their preventive roles.
Moving forward, healthcare policymakers and practitioners must collaborate to ensure that preventive care receives the attention and resources it deserves. This includes recognizing the importance of GPs in delivering preventive services and supporting them with the necessary tools and training to optimize patient outcomes.
In conclusion, preventive care is not an optional extra but a core component of effective general practice. By prioritizing prevention, GPs can play a pivotal role in reducing the burden of chronic diseases and enhancing the overall health of the population.
