Patient-Centered Communication: Focuses on adapting communication style to the patient’s
sociocultural background
literacy level
individual needs.
This includes
empathy
active listening
addressing the patient’s concerns
expectations and ideas during consultations.
Verbal and Non-Verbal Skills: Effective use of both verbal (e.g., open and closed questions) and non-verbal (e.g., body language, silence) communication techniques. This includes adapting explanations using various formats (e.g., written or electronic) to suit the patient’s understanding.
Dealing with Difficult Situations: Handling challenging consultations, such as breaking bad news or managing agitated patients, requires using structured models like SPIKES for delivering bad news and de-escalation strategies.
Consultation Structuring: Ensuring that consultations are focused, prioritize key issues, and fit within a standard consultation time frame. This involves effective safety-netting and clear follow-up arrangements to mitigate risk.
2. Clinical Information Gathering and Interpretation
Comprehensive History-Taking: Includes biopsychosocial history that covers medical, psychological, social, and cultural aspects. Hypothesis-driven history helps confirm or exclude likely diagnoses, focusing on patient-reported symptoms and cues.
Physical Examination: Physical exams should be respectful, targeted, and consent-driven. Emphasis is placed on detecting relevant clinical signs and interpreting them correctly in the context of the patient’s presentation.
Investigations: Choosing evidence-based, appropriate, and cost-effective diagnostic tests. Rational use of investigations involves understanding the patient’s context and minimizing unnecessary or harmful tests. Investigations should align with the most likely diagnoses.
3. Diagnosis, Decision-Making, and Reasoning
Diagnostic Accuracy: A structured approach to differential diagnosis, considering key features of symptoms, epidemiology, and temporal courses. The aim is not just to make the correct diagnosis but to demonstrate logical reasoning and problem-solving.
Hypothesis-Driven Thinking: Gathering information based on hypotheses, refining differential diagnoses as more information (e.g., test results or patient feedback) becomes available.
Dealing with Uncertainty: Recognizing when information is incomplete or ambiguous, and knowing when to act or when it is safe to delay intervention.
Reflective Practice: Thinking critically about one’s own diagnostic process, reflecting on the reasoning behind decisions, and identifying learning opportunities.
4. Clinical Management and Therapeutic Reasoning
Patient-Centered Management: Developing a management plan that takes into account the patient’s individual circumstances, preferences, and health literacy. This involves balancing pharmacological and non-pharmacological interventions (e.g., lifestyle changes, physical therapy).
Safe Prescribing: Familiarity with therapeutic agents, their uses, dosages, and side effects. Rational prescribing involves choosing appropriate medications, minimizing polypharmacy risks, and using legal frameworks for restricted drugs.
Multidisciplinary Approach: Involvement of various healthcare professionals (e.g., allied health, specialists) in developing comprehensive care plans, especially for complex or chronic conditions.
Therapeutic Reasoning: Ability to justify clinical decisions based on evidence and the patient’s specific needs. This includes the management of co-morbidities and uncertainty in chronic or undifferentiated conditions.
5. Preventive and Population Health
Screening and Prevention: Proactive identification of individuals at risk of common diseases, and implementing screening and prevention strategies (e.g., vaccinations, cancer screening). This includes opportunistic care during routine consultations.
Health Promotion: Engaging patients in discussions around lifestyle changes (e.g., diet, exercise, smoking cessation) and providing actionable advice to reduce health risks.
Public Health Risk Management: Identifying emerging public health risks (e.g., infectious diseases, vaccination campaigns) and implementing appropriate responses (e.g., contact tracing, notification to health authorities).
Community Engagement: Understanding and utilizing local health resources and services to promote patient care. This includes working with multidisciplinary teams to ensure that patients can access the care they need.
6. Professionalism
Ethical Behavior: Adherence to medical ethics, including maintaining patient confidentiality, respecting autonomy, and avoiding conflicts of interest. Awareness of professional boundaries and duty of care is crucial.
Self-Awareness and Reflection: Engaging in reflective practice, seeking feedback, and being open to change. This involves regularly reviewing performance and actively participating in professional development activities.
Critical Incident Management: Identifying and responding to critical incidents (e.g., adverse events) by addressing immediate consequences, reviewing the incident, and implementing strategies to reduce future risk.
Commitment to Continuous Learning: Demonstrating a commitment to lifelong learning through regular participation in clinical audits, quality improvement activities, and professional development programs.
7. General Practice Systems and Regulatory Requirements
Use of IT and Recall Systems: Using IT systems to improve patient care, maintain comprehensive records, and implement recall systems to follow up on test results and management plans.
Legal Documentation: Completing required legal documentation (e.g., fitness to drive assessments, work capacity certificates) accurately and in accordance with regulations.
Infection Control: Following best-practice infection control guidelines, including hand hygiene, immunization, and body fluid spill management.
Confidentiality and Consent: Managing patient confidentiality appropriately, including exceptions (e.g., mandatory reporting), and ensuring informed consent for examinations, procedures, and management plans.
8. Procedural Skills
Wide Range of Skills: Competence in a variety of procedural skills relevant to general practice, performed to a high standard while maintaining infection control. This includes gaining informed consent and documenting procedures.
Referral When Necessary: Recognizing when a procedure is beyond the GP’s scope of practice and making appropriate referrals.
9. Managing Uncertainty
Undifferentiated Conditions: Developing a structured approach to managing conditions with uncertain diagnoses. This involves excluding serious conditions, choosing rational investigations, and utilizing time as a diagnostic tool (e.g., watchful waiting).
Decision-Making in Ambiguity: Knowing when to intervene and when to delay action. This is particularly important in managing chronic conditions or conditions with ambiguous symptoms.
10. Identifying and Managing the Patient with Significant Illness
Early Identification: Recognizing life-threatening or potentially serious conditions early, and managing these in line with accepted clinical guidelines.
Taking Responsibility: Taking ownership of clinical decisions while being aware of personal limitations. This includes continuous learning and reflection on areas for improvement.
11. Aboriginal and Torres Strait Islander Health
Culturally Safe Communication: Developing effective communication skills tailored to Aboriginal and Torres Strait Islander peoples, taking into account their cultural perspectives, health beliefs, and historical context.
Holistic Management: Incorporating social and cultural determinants of health into management plans, optimizing health outcomes by early identification of conditions, and addressing barriers to effective care.
Health Promotion and Self-Determination: Supporting community-led initiatives, using Medicare programs to improve health outcomes, and advocating for health equity.
12. Rural Health
Adapting to Rural Practice: Rural GPs need to manage broader and more complex cases with limited resources, requiring flexible and innovative approaches. Communication with remote health professionals and emergency preparedness are key.
Leadership in Emergencies: Rural GPs often take leadership roles in emergencies, working with local hospitals and emergency services to optimize preparedness.
Public Health and Health Promotion: Developing health-promotion activities suited to the community and overcoming barriers to accessing care, often through collaboration with government and non-government organizations.