General practitioners' perceptions of after hours primary medical care services: A Toowoomba, Queensland, Australia study

INTRODUCTION: This article reports on a project, undertaken in 2002 in the regional city of Toowoomba, Queensland, Australia, that investigated the viability of establishing an after-hours primary medical care (AHPMC) service. OBJECTIVES: To ascertain GPs' perceptions of the adequacy of AHPMC services in Toowoomba. DESIGN: Thirty GPs were randomly selected to participate in face-to-face interviews using a semi-structured interview tool. SETTING: Toowoomba, Australia is the largest inland non-capital city in Australia. It is located approximately 130 km west of Brisbane, the State capital city and is a referral centre for patients from the rural and remote communities of south-west Queensland. PARTICIPANTS: 15 male and 15 female GPs. RESULTS: While the majority of participants believed the current provision of AHPMC in Toowoomba was adequate, they stated that the provision of AHPMC services was onerous and, given a choice, they would prefer to refer all patients seeking care between 2200 and 0800 hours to an Emergency Department (ED). Similar to GPs who work in rural and remote areas of Australia, they believed that AHPMC work was poorly remunerated, had an adverse effect on their lifestyle and could endanger their personal and their patient's safety. CONCLUSION: The findings of this study confirm previous studies into the perceptions of GPs to the provision of AHPMC in a regional city. Additionally, while the GPs in Toowoomba have the options of referring after-hours patients to an ED and being part of a large GP after hours cooperative, their opinions on after-hours work did not differ significantly from those expressed by GPs working in rural and remote areas of Australia. The GPs in this study, given the option, would prefer not to undertake an AHMPC service provision between 2200 and 0800 and many had chosen not to do so, instead directing their patients at this time to one of the two EDs located in Toowoomba.