M. Montalto et al., TRUE BELIEVERS - CHARACTERISTICS OF GENERAL-PRACTITIONERS IN VICTORIAN COMMUNITY-HEALTH CENTERS, Australian journal of public health, 18(4), 1994, pp. 424-428
General practitioners have been part of multidisciplinary services in
Victorian Community Health Centers (CHCs) for 20 years. This model ins
titutionalises a high degree of integration between general practition
ers and other primary care and community service personnel. Of 51 elig
ible full-time general practitioners in Victorian CHCs, 46 were interv
iewed, using a structured questionnaire. General practitioners in CHCs
were younger, less experienced and more likely to be female than othe
r general practitioners. Nearly three-quarters were salaried. The phil
osophy of practice and the conditions of employment were the commonest
reasons for entering CHC practice. Teamwork and the conditions of emp
loyment were felt to be the biggest advantages of CHC practice, while
difficulties with management and the perceived loss of professional ow
nership and control were the commonest disadvantages. None reported in
terference from the CHC management in their clinical practice. Nearly
a quarter of full-time CHC general practitioners do not undertake any
formal community health promotion activities. Forty-five per cent of r
espondents intended to leave their CHC within the next five years. Uni
versal health insurance has diminished the impact of CHC general pract
ice. The philosophy of CHCs and the salaried nature of the employment
continues to attract general practitioners. High staff turnover is a f
eature of CHC general practice, in part related to young doctors makin
g an initial, but not long-term commitment to CHC practice. However, t
he loss of professional control and management difficulties should be
addressed, as these may contribute to the high turnover.