Preparing for an ageing population: a survey of older patients' attitudes to general practice registrars

Introduction: The ageing population makes it imperative to provide appropriate training for general practice registrars (GPRs) in the community-based care of older patients. However, data suggest that older patients may be less willing to consult GPRs for chronic/complex care; adversely affecting training opportunities and potentially the satisfaction of older patients in training practices. This cross-sectional study was undertaken to investigate this concern in the Australian context and develop models of older patient-GPR interaction that are acceptable to patients.

Method: Ten GP training practices in regional Australia each provided 50 patients aged 60 years and older with a questionnaire for self-completion. The questionnaire included demographic items and Likert-scale items assessing the patient’s attitudes to registrars. Chi-square, Spearman’s rho and logistic regression were used for analysis.

Results: The response rate was 47% (n= 233). Most respondents felt it required time to develop trust with a new doctor (65.8%), and almost all wanted their ongoing contact with their regular doctor preserved if they saw a GPR (96.1%). Twenty-four per cent of respondents were comfortable with having a GPR manage a chronic/complex problem alone; this increased to 73.1% if their usual GP made personal contact during the consultation (p<0.001).

Discussion: This study quantifies a widespread reluctance amongst older Australian patients to GPRs managing chronic/complex conditions, with the potential for a detrimental impact on registrar learning opportunities. Older patients’ acceptance of GPRs for chronic/complex care may be significantly enhanced by maintaining a relational link between patients and their regular GPs around GPR consultations. These results warrant further research.