The Role of a General Practitioner in Everyday Healthcare: A Belconnen GP Perspective

The Role of a General Practitioner in Everyday Healthcare

There was this one day when I was asked by a patient, “So what exactly do you do all day?” It was an honest question from someone who’d only ever needed a GP for a sick certificate or a course of antibiotics. Initially, I almost felt insulted; didn’t they see? I was here treating their respiratory infection. But I knew that the question was pointing to something: Most people don’t know what GPs do.

The reality is that the whole of what occurs in a GP’s consulting room goes beyond the face-to-face consultation. We’re conducting medical sleuthing, arranging complicated care, trying to prevent disease before it happens, and sometimes simply being the person someone can talk to about their health concerns. This is the actual work of a GP.

The First Point of Contact: Why It Matters

People are the first to see me when they have a problem every day. A mother sees a rash on her two-year-old and is concerned; she calls us. A middle-aged man complains of chest discomfort and is uncertain about the severity of the complaint; he comes to me first. An elderly woman’s memory seems to be getting worse; her daughter books a GP appointment.

This “first point of contact” position is more important than it’s often thought to be. I am frequently making decisions that impact the whole medical course of a person’s life. Are they a specialist referral? Are they in immediate need of hospitalisation? Is this something that can be managed in primary care with reassurance and monitoring?

I recently came across a woman who thought she had cancer due to a longstanding cough. She was terrified. In secondary care, she may have had several expensive investigations and someone may have comforted her. I took the time to listen to her symptoms, examine her, review her medical history (she had a history of acid reflux), and help her understand that her symptoms were most consistent with postnasal drip from allergies. We treated that and she cleared up her cough in weeks.

Was she right? No. Did she have reason to be concerned? Absolutely not. However, having someone carefully review her, take her situation into account, and offer the right kind of reassurance is important healthcare that avoids unnecessary tests and procedures and helps solve her problem.

Acute Illness: The Tip of the Iceberg

Yes, I treat acute diseases. A large percentage of my day is spent dealing with colds, flu, urinary tract infections, twisted ankles, skin infections, etc. For many patients, this is all they see. They arrive with a problem, and I solve it, and they leave. Done.

However, many people are not aware of this: the way I treat acute illnesses is based on principles which are important for their long-term health. When a young man comes in with a cough and fever, I’m not just asking, “Does he have pneumonia?” Also considering: “Does he smoke? Are there any risk factors for chest disease? Has his mental health remained stable and thus his immune function?”

Several patients presented with recurrent urinary tract infections a few years ago. Antibiotics may be prescribed by any GP. However, I wondered why this was occurring so often. I asked them about water, sex, cleanliness, etc. I covered sensitive topics but had to cover them. It was revealed that she had been in an abusive relationship and was embarrassed to talk about it. This was partially due to her situation, and she had urinary tract infections.

When I saw the patient with acute illness, I could not only treat the infection, but also the underlying issue because it was a window into their overall health and life circumstances. She has eventually left the relationship with support. The UTIs were halted after a few months. The strength of good primary care.

Prevention: Years later, the Work That Saves Lives

The fundamental principle of general practice is that of prevention, but it is the work that no one sees and appreciates. If I detect hypertension in someone’s blood pressure when it is going to happen, I am stopping a stroke from happening in 5 years. If I can recognize prediabetes and get someone to change their food and activity, and I can prevent them from having to manage diabetes for the rest of their life, then I’m doing a service to them.

Prevention isn’t solely about screening. It is all about behaviour change, and behaviour change is hard work.

I had a patient, David, who came in at the age of 38 with high cholesterol and early heart disease in his family. Classic risk profile. I described the research, talked about lifestyle changes, and provided medication. He paid attention and went away. Two years later, he returned with the same cholesterol levels, no changes to his lifestyle, and he was not taking his statin pills.

At the age of 51, his father suffered a heart attack.

Then, prevention became real. It was personal. We sat at a table and talked about other things. Rather than talking about health, I asked him what his fears were. What was the worst thing he saw in his father’s experience? What did he do? For the next year, we did things together: he began walking with a friend three times a week, he reduced his sugar intake, he took his medication regularly. His cholesterol improved. His blood pressure came down.

The key is to be where patients are, to understand what drives them, and to work with them in a realistic way to make changes. This is not a universal piece of advice. It’s personalized healthcare.

Chronic Disease Management: The Long Game

I have about 40% of my practice devoted to chronic diseases, such as diabetes, hypertension, asthma, heart disease, and arthritis. They need continuous care, frequent adjustment of drugs, and prevention of complications.

I am currently managing a 62-year-old man who has type 2 diabetes, hypertension, and early kidney disease. He is seeing a cardiologist and an endocrinologist, and I’m his quarterback. I liaise between various specialists, make sure that his medicines are compatible with each other, keep an eye on his kidney function, and adjust his medicines as necessary.

It’s not a single medical decision that makes the difference; it’s continuity and coordination. I am familiar with his current treatment as I have prescribed most of his medications. I am aware of his past treatments and why we discontinued some of his treatments. I have an understanding of his family situation, his dietary preferences, and his ability to follow complicated diets. If his blood pressure meds cause him to get dizzy, I can tweak it before it is a safety concern. If the endocrinologist recommends a new diabetes medication, I look for drug interactions with other medications he is taking, or an easier way to do it.

Mental Health: The conversation that doesn’t always happen

One thing I would like all my patients to know: Mental health is health. Full stop. It’s not separate. It’s not secondary. It’s right at the core of wellbeing.

Depression is screened routinely in my practice. Not because any and all who come in suffer from depression, but because depression is a very common condition and many people do not get diagnosed with it. I’ve seen depression in successful attorneys, stay at home moms, stay at home dads, and teenagers. I have had patients who thought that their fatigue was due to physical causes only to find out that it was not; that it was due to depression.

One patient told me that in five years of seeing her previous doctor, who was a competent specialist, she never had her mental health discussed. I asked her directly, “How are you doing emotionally?,” and she felt relieved. We discovered that she had a lot of anxiety and that it was impacting her physical health, sleep and self-care. After dealing with it, she got her body back.

Medication Expertise: Beyond the Prescription.

Medication knowledge and management is one aspect of general practice that is truly undervalued. I spend a good deal of time reading about medications, knowing which ones aren’t necessary, how they interact, what really works, and what’s just done because it’s there.

I saw a patient who was on 9 medications. After reading them carefully, three were out-of-date (prescribed years ago, but not canceled), one was causing another side effect (which was being treated with another drug, thus creating a cascade), and one was actually raising his blood pressure (which was being treated with another drug). We slowly decreased his medication to just five essential ones. His side effects got better. The simplicity of the regimen allowed him to be more compliant.

This course is designed to help students understand how to create a relationship that enables everything.

The most crucial part of my job as a GP is the relationship I have over the years with patients. I know them. I understand what is normal for them, what they are concerned about, what is important to them. This knowledge helps me to become a better doctor.

I can see slight changes. I am familiar with the patients who will follow instructions and those who will not. I know what they’re afraid of and can speak to them about it. When bad news arrives (new diagnosis, worrisome test results), they rely on my ability to be honest, and support them in what lies ahead.

A GP’s role in a person’s everyday health care is complex, multifaceted and very meaningful. Medicine at its human level.

You Don’t Have to Figure It Out Alone

Got health questions that have been sitting in the back of your mind? A weird symptom you’re not sure about? Worried you might be overreacting? That’s exactly why we’re here.

Our GPs listen, ask the questions that actually matter, and help you make sense of what’s going on. No judgment. No unnecessary tests. Just straightforward healthcare from someone who genuinely cares.

Your health matters. Let’s talk about it.

Make an Appointment

Call Us: (02) 6251 1234

Address Belconnen General Practice:  Unit 12, 1 Grazier lane.Belconnen ACT 2617

FAQs

1. So what is the difference between a GP and a specialist?
   
   Remember, a specialist is a surgeon who specializes in one particular field, and they’re good at what they do. A GP is a generalist with a wide range of knowledge and experience in every area of medicine and knows how to organise care. You visit a GP first as we treat 90% of health issues that come through the door. Specialists are called in when we need to know more than we can. There is a difference in that GPs look at the whole person, whereas specialists look at their particular area. 
2. Why does my GP do things that aren’t medical? 

   They can frequently have an impact on your medical health. If you tell me how stressed you are, whether you have a family or your job, I’m not being nosy, I’m asking you so I can get information about things that affect your health. A major life stressor can be a cause of a heart attack. Loneliness is a risk factor for depression. Exercise recommendations are dependent on the physical demands of your job. Context is key to better clinicians. 

3. Is my GP able to help me with my complex health issues? 

   Yes and no. Many complex conditions can be managed directly (diabetes, heart disease, COPD). But if something is truly beyond our expertise, we coordinate specialist referral and then continue to be your primary coordinator. We do not leave people after they see a specialist, we continue to work with them and make sure the pieces fit together and they are not getting conflicting advice. 

4. “Let’s monitor this” – why does my GP say this rather than do something? 

   Not everything that can be done, should be done. Most minor symptoms will go away on their own. Over-investigation results in unnecessary anxiety and may lead to incidental abnormalities found that are not required for treatment. My job is to know when to attack and when to watch and wait. Patience can be a better remedy than action. 

5. What is the benefit of having the same GP? 

   Enormously. After 5 years I know your basics. I am aware of subtle changes. I know your values and your fears and your reliability. New symptoms are contextual. I remember that you’ve had previous medication allergies. I understand what tests we’ve already done. This information helps to speed up diagnosis and tailor treatment. Each time you visit a new doctor, they have to start all over again and you have to explain your history again and there’s no context.