History of General Practice in Australia and Beyond
Prior to the mid 20th century, upon graduation Australian doctors spent time in general practice. A medical career usually included completing an intern year immediately after graduation as a resident in a major teaching hospital. After a period of time in general practice, some doctors would seek specialist qualifications. Possibly reflecting the historical origins of Australia as a series of British colonies, these doctors would travel overseas, most often to the UK, to specialise and then return to establish practice.
As the Australian population grew post World War II, the public hospital system also grew demanding an increasing number of specialists. Local training program emerged and therefore the ability of a doctor to enter specialist training directly following the mandatory intern year post graduation without entering general practice. This increasing number of specialist made it increasingly difficult for general practitioners in Australia to hold and retain public hospital appointments, especially in procedural areas such as surgery or obstetrics.
This was not a uniquely Australian phenomenon. Worldwide, medical practice was shifting focus onto hospitals with the expansion of pharmaceuticals and medical and surgical interventions. In the United States, the number of doctors identifying as General Practitioners fell markedly between 1931 and 1974 from 83% to 18%. This process began as specialisation increased prior to the War. US GPs increasingly felt that health care was becoming fragmented and weakening doctor patient relationships.
“There are 57 different varieties of specialist to diagnose and treat 57 different varieties of disease but no physician to take care of the patient."
Read more about this topic: Royal Australian College Of General Practitioners
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