Nine out of 10 practice owners reckon the accreditation process is too authoritarian and ideological, national poll finds…

Unnecessary questions and requirements, too much bureaucracy, and an onerous, inflexible approach are plaguing the GP accreditation process, a survey of more than 300 practice owners has found.

Ninety-two percent of practice owners said the process needs to be more collaborative and less authoritarian, while a similar proportion noted unnecessary mandatory requirements and questions.

Dr Mukesh Haikerwal, past AMA president and former practice owner who has helped many GPs through the accreditation process, said that while the rationale for accreditation was to prove a level of competency and a consistent standard across practices, it was by no means universally accepted.

Despite good intentions, the process has gone off the rails in many ways, he added.

“I think that the whole thing has now become overburdensome and is causing an awful lot of annoyance because of the overreach,” Dr Haikerwal said.

“The inspectors that come and inspect practices do ask unnecessary and intrusive questions, which probably aren’t even part of the accreditation standards. And then the accreditation standards themselves have got more and more obstructive rather than supportive to general practice.”

It’s expensive

Accreditation is expensive, with just 30% of practice owners saying that Practice Incentive Program (PIP) payments cover the cost.

Initially, accreditation wasn’t meant to be tied to incentive payments, Dr Haikerwal notes, but somewhere along the way that changed.

While over two-thirds of 1240 GPs (68%) think it’s appropriate to require practice accreditation in order to access PIP payments, smaller practices and practice owners are significantly less likely to agree with this.

“Smaller practices are less likely to be accredited because the cost of accrediting and the gains from PIP don’t pay off the investment,” Dr Haikerwal said.

“I’ve certainly helped many practices to get accredited because the financial viability of practices was dying off and it was another potential supply of practice incentive to help with practice costs. But what’s happened is that the quid pro quo has worn away.”

While it can be a good learning tool for improving practice management, Dr Haikerwal believes that too many standards have made the process increasingly complex and difficult to manage.

Ideology over practicality?

Some of the requirements are ideological rather than practical, according to 89% of GPs.

Dr Haikerwal points to very specific requirements for equipment or facilities that don’t allow flexibility for the individual circumstances of a particular practice.

“For example, if you have a room that’s got a door that shuts and no windows or drapes on the windows, the need to actually then have curtains around the examination couch when you’re in a closed room is another additional cost burden. And the benefits are questionable,” he said.

“That’s the sort of thing, that depending on how you work, you can probably be very mindful of your patient without necessarily having to do that.”

GPs in the survey echo this point.

“Some of the criteria are nonsensical e.g. we were recently required to have examination lighting ‘calibrated.’ Others are clearly necessary, but well within in-house expertise, yet we’re required to use external consultants, for example to check calibration of weighing scales. This process cost our small practice nearly $3000,” one practice owner explained.

“There is no recognition of common sense or professional responsibility.”

What your colleagues are saying

“I had everything in place, but they failed me on some trivial matter. I was so disappointed I did not reapply. I am missing out on lot of incentives.”

“It has become too expensive and difficult for a small practice.”

“Overall accreditation is necessary to ensure practices at least maintain good standards, although there could be some flexibility.”

“Re-accreditation interval should be reduced to five yearly.”

“Reduce bureaucracy. It needs to focus on patient care rather than the latest woke content.”

“I have PTSD from my last encounters with unpleasant accreditations. However, I am a solo practitioner and therefore feel that I have to continue, irrespective of my increased need for alcohol and Panadol!”

“Single GP Aged Care practice in a nursing home does not fit with an onerous and costly accreditation process. GPs must meet the criteria of the Aged Care Quality and Safety Commission Standards and AHPRA and that should be sufficient for nursing home care.”

“The accreditation process does not fit the solo practice, who has to undergo the same procedures as the big co-operated medical centres with many doctors.”

“Very few patients care about accreditation.  The best thing I did is to get out of it after being in it for decades.”

“Another good idea that has been manipulated by external interests.”