Bizarre research article about parental confidence in GPs gets a mention in ABC’s Media Watch

In an earlier post I mentioned the bizarre article published by a paediatrician from the University of Melbourne.

The article concluded incorrectly that “confidence with GPs is an issue for parents of many walks of life”. The paper was rejected by the Royal Australian College of General Practitioners (RACGP) and the Australian Medical Association (AMA).

The odd conclusions from the authors were reported by prime time media which in turn drew the attention of the ABC TV show Media Watch.

The article and subsequent reporting by some journalists attracted harsh criticism from presenter Paul Barry. And rightly so…

Bizarre research article about parental confidence in GPs gets a mention in ABC’s Media Watch
Media Watch sets the record straight: Most parents have confidence in their family GP. Source: Media Watch

The background

The authors reported the results of a survey about the confidence parents have in the paediatric care by Australian GPs. The survey was published in the Journal of Paediatrics and Child Health.

The findings showed that most parents are confident in their GP (only 2% of respondents was not very confident), yet the authors stated that “fewer than half of parents are completely confident in their GP to provide general care to their child (…).”

The authors conveniently omitted the ‘mostly confident’ category (45%) and only reported the ‘completely confident’ category (44%) as their main result. They then went on to conclude that this could potentially lead to “greater numbers of ED presentations for children with lower urgency conditions” and also suggested that GPs needed more paediatric training.

#trustaGP

Record set straight

The poor research quality coming from the University of Melbourne has raised eyebrows. GPs voiced concerns that, as a result of the paper and the incorrectly informed media coverage, some parents may take their sick children to the emergency department (ED) instead of the GP.

But ABC’s Media Watch has now set the record straight.

In a reply on this blog lead author Professor Gary Freed previously said: “If you do not like how we presented the results of this parent survey, for whatever reason, I respect that. However, I sincerely hope that does not result in you and others ignoring the underlying issue of worrisome changes in paediatric care and education among GPs.”

We now know that these ‘worrisome changes’ are not confirmed by the results of Professor Freed’s survey which clearly shows that most parents have no problem with the care provided by GPs.

View ABC’s Media Watch here.

New study shows high parental confidence in GPs, but researchers draw bizarre conclusions

High confidence in GPs

A new national study published in the Journal of Paediatrics and Child Health shows that around ninety percent of parents are mostly or completely confident in GPs to provide general care to their children.

This is of course good news.

The findings also show that 93% of the parents participating in the study reported that they would take their child to see a GP in the event of a minor illness, instead of visiting the emergency department – which is exactly what everyone wants.

Therefore I was surprised to read the conclusion from the authors, a group of mainly academic paediatric researchers, that “confidence with GPs is an issue for parents of many walks of life” which could potentially lead to “greater numbers of ED presentations for children with lower urgency conditions.”

Sorry? The results of the study clearly show that only 2% of parents were not very confident in their GP (see table). I wonder what is going on here.

Most parents are confident in their GP. Only 2% of respondents was not very confident. Source: Journal of Paediatrics and Child Health.

 

The authors conveniently omitted the ‘mostly confident’ category (45%) and only reported the ‘completely confident’ category (44%) as their main result, stating that “fewer than half of parents were completely confident” in a GP.

I wonder how many consumer satisfaction studies show a 100% score all the time… The bottom line is that many people inherently have fears when it comes to their own health and especially the health of their children. This may be reflected in their attitudes in confidence of health care services, but this is often a natural fear and as a profession we need to support our patients and address their fears and concerns.

More bizarre conclusions

It appears the authors have a different agenda, as they went on: “Given that GPs in training are having limited experience in child health and that GPs are seeing fewer children overall, more intensive training pathways for paediatric care may be beneficial. One option would be for additional training similar to the certificate for GP provision of antenatal care.”

Additional training? Current GP training already includes childhood conditions as this is core general practice business. GP waiting rooms are full of children and most childhood conditions and preventive health are managed successfully by GPs.

We know that Australia has one of the highest life expectancies in the world, partly because Australian general practice is accessible and offers longitudinal care.

The findings of the study also confirm that parental confidence is greater for those with a regular GP, so instead of providing advice about more intensive training pathways, it would have been useful if the authors had recommended that parents find a regular family GP they trust.

Seeing a GP who is a RACGP Fellow (Royal Australian College of General Practitioners) should serve as reassurance to parents that they are seeing a specialist GP who has trained at the highest possible general practice standard in Australia – including child health and antenatal care.

There are of course challenges with doctors coming into GP training in this area. In recent years, the access of junior hospital doctors to paediatric experience in hospitals before entering GP training has decreased. Like all training and learning needs, this is taken into account when supervising GP trainees to ensure patient safety.

National study of parental confidence in general practitioners
It would have been useful if the authors had recommended that parents find a regular family GP they trust. Source: Journal of Paediatrics and Child Health.

Not helpful

If there is some area we need to do better, we need to know that but based on the findings of this study I don’t see a major problem with the paediatric care provided by Australian GPs.

My take-home message from this study is first of all that this style of reporting research findings is, at best, not helpful.

Secondly, the study clearly demonstrates the need for quality research in general practice, in terms of improving access to high value treatments and the appropriate use of limited health resources.