I see general practice as a technology wasteland. The problem is that while many useful technologies exist, these are neither designed to work in nor priced for general practice. Since the electrical rhythm of the heart was first recorded at St Bartholomew’s hospital in 1872 and the subsequent development of the ECG machine, there has been little in the way of major technology uptake in general practice. There are some notable exceptions; the spirometer is used reasonably often while clinic-based blood sugar, INR and SO2 measurements are definitely very useful and very affordable. Yet while individual patients regularly invest in these laboratory technologies, many practices do not.
The obvious example of a technology suitable for general practice is the ultrasound. First, it is a visual tool and can be seen by the doctor and patient. Second, real time imaging is essential for interpretation. Third, it both requires and enables maintenance of anatomical knowledge which is itself useful for primary care doctors. Finally, it is a massive convenience for our patients if we can exclude an intrauterine death, see an intrauterine pregnancy, look for subcutaneous foreign bodies or drainable collections, do guided injections and the like. It is so obvious that this will be a key technology for GPs – it is safe, not expensive and provides value for patients who can also see what is going on. We need to work with companies developing ultrasound equipment to get it right for our setting. This will not displace radiologists but extends a service and convenience for our patients.
I do not want to decide which technologies might be taken up by GPs. There are so many to choose from. I would like our College to support the adaption of useful technologies for use in general practice, assist those wanting to pioneer use and then be custodian for the knowledge and skills-base required to implement the technology successfully for the benefit of our patients. This might be a useful app on a smart phone or a complex integrated fibre optic camera to view places difficult to see! Only our imagination will limit the possibilities.
Let the dance begin. The RACGP is the rightful facilitator and custodian of these endeavours.