Scope extended to all areas other than general practice
16 Sep 2025
As Australia faces an ageing population and more complex medical needs, the Federal Government has emphasised the importance of healthcare professionals being empowered to work to their full scope of practice. The aim is to improve access to care, address workforce shortages, increase system efficiency, and reduce costs. Initiatives so far include pharmacy prescribing trials and expanding the role of nurse practitioners.
However, some GPs say these efforts are leaving general practice behind, with doctors facing increasing administrative and regulatory barriers. Professor Louise Stone, a GP and medical educator, says the only significant expansion of GP scope she has seen recently is in ADHD care.
“It's an expansion of scope for everyone except general practice,” Professor Stone told newsGP. “I can’t order a continuous glucose monitor, diagnose mental illness for disability support, or order an MRI for conditions like multiple sclerosis. Meanwhile, nurses and pharmacists can perform certain tasks I can’t.”
She also highlighted the risk this creates for patients. Pharmacy prescribing protocols may work for many, but patients with complex or serious conditions may be overlooked. Professor Stone warned that relying on protocol-based care could lead to harm for those not fitting the average case.
Adding more healthcare providers to patient care can also complicate communication, especially for patients with multiple chronic conditions. “Every time you add someone to the team, communication becomes more complex. It’s more work for the patient and carer, and there’s more room for disagreement,” she said.
Professor Stone questioned whether cost savings from expanding non-GP roles are realistic. Using cheaper workers may not save money if care takes longer or becomes more fragmented. She also raised concerns about funding models incentivising shorter consultations, which can undermine the viability of general practice.
Another issue, she says, is the assumption that healthcare is about delivering a product rather than recognising the expertise and diagnostic skills of doctors. “Patients may get access to a vaccine or medication, but they’re not getting access to the diagnostic training and experience of a GP,” she explained.
These pressures are contributing to burnout and early exits from general practice. According to the RACGP’s Health of the Nation survey, besides retirement, key reasons GPs leave are administrative burdens, lack of respect, reduced autonomy, and moral distress. Professor Stone said she hears the same concerns from her colleagues. “I love my job, but many can’t survive the environment. We’re losing experienced GPs faster than ever,” she said.
The concerns highlight that while government reforms aim to improve access and efficiency, overlooking the full potential of general practice may have serious implications for both patient safety and the sustainability of the healthcare system.
Source: newsGP
