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Palliative Medicine
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General practitioners and palliative care

Melanie A Wakefield

Senior Behavioural Scientist, Behavioural Epidemiology Unit, Epidemiology Branch, South Australian Health Commission

Justin Beilby

Research and Health Promotion Unit, Royal Australian College of General Practitioners

Michael A Ashby

Mary Potter Hospice, Director of Palliative Medicine and Radiation Oncologist, Royal Adelaide Hospital, Australia

A randomly selected sample of 158 South Australian general practitioners (GPs) were sent a questionnaire which assessed opinions and management practices in the palliative care of terminally ill patients. A total of 117 responses (74%) were received. Most GPs were at least moderately satisfied with the care they were able to give their terminally ill patients, although a substantial number reported difficulties in pain and other symptom control, dealing with relatives' emotional distress and attending to patients' psychosocial needs. There was considerable support for continuing education in these aspects of palliative care. More than half were at least somewhat concerned by opioid side effects and impairment of cognitive function, although opioid dependence was not a concern. Considerable dissatisfaction was expressed with public hospital care for the terminally ill and most felt excluded from decision-making once their patients were admitted. The findings suggest that continuing education is required for GPs and that palliative care should become an integral part of undergraduate education. There is also a need to enhance communication and co-ordination between hospital and community-based services for the terminally ill.

Key Words: education (medical • continuing) • graduate medical education • hospitalization • pain • palliative treatment

Palliative Medicine, Vol. 7, No. 2, 117-126 (1993)
DOI: 10.1177/026921639300700205
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