Research study reveals GP registrars carry heavy burden of responsibility without life experience to rely on, and tools pharma can use to help
GP registrars are under such stress that they are seeking out peers and crowd support to help them feel more confident in their jobs, an AusDoc survey has revealed.
The Project Pathway survey asked registrars about the tensions they face and what they feel they need from the healthcare industry to improve their experience of the job.
The survey found that registrars are vulnerable to trauma, anxiety and stress. They are expected to be confident in their diagnosis, but have very little experience on which to base their decisions – and they are understandably reluctant to get anything wrong.
So what did the GP registrars say they needed to help ease their anxiety about the job?
They expressed a need for five key things – including resources to aid new and complex decision-making, but in particular they wanted a connection with peers and greater access to specialists.
1. Online resources
One GP registrar said: “As I have done a lot of training previously, I have been given more independence, so I have my own patients now, who would see me as their doctor. I use a number of resources to help me with management and clinical decision-making. It was quite a learning curve to get used to different resources, which we as GPs need to get used to.”
GP registrars use a variety of point-of-care resources to help them with consultations, often referring to them during the consult.
- AusDoc with How to Treat articles and Spot Diagnosis
- Government-backed GP support programs such as the Western Victoria HealthPathways initiative
- online resources such as eTG, MIMS, the Australian Medicine Handbook and UpToDate
- specialty-specific websites such as DermnetNZ or Orthobullets
- specific guidelines, such as those from the Heart Foundation
- specific societies and hospital resources, for example the Australasian Menopause Society for patient information on menopause
2. Patient handouts
The registrars surveyed called for more links to patient fact sheets and handouts to help them during consultations, as they see this as an important component of patient care.
3. Peer-to-peer networking
The GP registrars said they sought input from others to help relieve their sense of self-doubt when making a diagnosis or reviewing an unusual case.
While they may ask their superiors in the practice, some shy away from this – typically, they rely on other registrars or GPs in their network, for example, by joining WhatsApp groups.
One commented: “I used WhatsApp for connecting with other registrars in my practice as we find it helpful to ask each other questions with things we might be uncertain about or suggestions who to refer to or who to contact for a certain problem.”
4. Crowd learning
Typically, the registrars surveyed said they were involved in some form of crowd-based learning, or crowd-based case study review. Even if they did not upload their own cases for others to review, they found this a valuable medium for practical learning.
However, there were some concerns: “I am bit hesitant to do this on Facebook. While it is secure, you don’t really know of the credibility of people on there.”
One solution is AusDoc Groups, a recently launched function on the AusDoc website in which doctors can post questions for clinical experts, share interesting patient cases and discuss hot topics with other clinicians, all in a secure environment exclusively for medical professionals. Currently, five special interest groups have been launched, with more in the pipeline. These include: dermatology, women’s health, medicolegal, cardiology and coronavirus.
5. Connection with specialists
AusDoc Groups also helps with another need – the GP registrars surveyed said they wanted to be better connected to specialists, who could offer reassurance that they’ve made the most appropriate decision for a patient.
One said: “I am in a rural area and having a specialist I could ring for advice would be handy. I am slowly building my network but it is not quite there yet.”
While not designed as forum to discuss specific diagnoses, each special interest group in AusDoc Groups is chaired by a specialist in the field, with contributions from other specialists. This brings GP registrars, GPs and specialists together on a unique digital platform where they can safely share, debate, learn, connect and collaborate.
- Project Pathway 1 | Understanding Medical Students and GP Registrars, AusDoc, February 2021