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Background: Aboriginal culture stands as the oldest continuous culture in the world. It gives paramount importance to a harmonious balance between personal connections to the body, spirit, and mind, as well as collective relationships with family, land, and community, integral to the wellbeing of Aboriginal people. However, obstacles can emerge for patients due to language barriers, cultural differences, or a historical lack of trust in the healthcare system. The establishment of Aboriginal Community Controlled Health Organisations (ACCHOs) has undoubtedly improved the healthcare experience for Aboriginal patients, yet there is limited research on the specific approaches utilised by general practitioners (GPs) working in these clinics. Methods: Twelve semi-structured interviews were conducted with two groups of GPs working in Aboriginal health. Each GP was presented with three scenarios and asked questions related to each scenario. Braun and Clarke's method of thematic analysis was applied to transcribed interviews. Results: Patient-doctor relationship, health literacy, and engagement with the health system emerged as key factors influencing communication with Aboriginal patients. Experienced GPs, despite differing clinical backgrounds, shared concise yet similar ideas to their less experienced counterparts. Notably, experienced GPs prioritised non-medical conversations and mindful body language, emphasising the importance of building strong patient relationships over other consultation aspects. Conclusions: This research provides initial insights for GPs in Aboriginal health, comparing experienced GPs with more than 10 years experience to novices. However, further research involving Aboriginal patients is needed to validate GP strategies and understand their significance from the patients' perspective. Communicating health information can be a challenging skill to clinicians especially when working in Aboriginal health. Despite Aboriginal Health Community Controlled Health Organisations having enriched the experience of Aboriginal patients, there is limited research on the approaches adopted by general practitioners (GPs) working in these clinics. Our research combines thoughts from experienced and novice GPs who worked in Aboriginal Health, and shares some of their experiences related to communicating medical information with Aboriginal patients in this highly complex field. [ABSTRACT FROM AUTHOR]

Background: Advances in screening and treatments for colorectal cancer (CRC) have improved survival rates, leading to a large population of CRC survivors. Treatment for CRC can cause long-term side-effects and functioning impairments. General practitioners (GPs) have a role in meeting survivorship care needs of this group of survivors. We explored CRC survivors' experiences of managing the consequences of treatment in the community and their perspective on the GP's role in post-treatment care. Methods: This was a qualitative study using an interpretive descriptive approach. Adult participants no longer actively receiving treatment for CRC were asked about: side-effects post-treatment; experiences of GP-coordinated care; perceived care gaps; and perceived GP role in post-treatment care. Thematic analysis was used for data analysis. Results: A total of 19 interviews were conducted. Participants experienced side-effects that significantly impacted their lives; many they felt ill-prepared for. Disappointment and frustration was expressed with the healthcare system when expectations about preparation for post-treatment effects were not met. The GP was considered vital in survivorship care. Participants' unmet needs led to self-management, self-directed information seeking and sourcing referral options, leaving them feeling like their own care coordinator. Disparities in post-treatment care between metropolitan and rural participants were observed. Conclusion: There is a need for improved discharge preparation and information for GPs, and earlier recognition of concerns following CRC treatment to ensure timely management and access to services in the community, supported by system-level initiatives and appropriate interventions. Colorectal cancer survivors can experience ongoing side-effects and functioning impairments long after completing treatment. This study explored how colorectal cancer survivors manage their consequences of treatment in the community. Colorectal cancer survivors were interviewed about the side-effects they experienced after treatment; their experiences of general practitioner-coordinated care; perceived care gaps; and their perception of the general practitioner role in post-treatment survivorship care. [ABSTRACT FROM AUTHOR]

Background: General practitioners (GPs) have played an integral role in Australia's coronavirus disease 2019 (COVID-19) pandemic response. However, little is known about how GPs themselves have been impacted by the COVID-19 pandemic. This study aimed to increase our understanding of the experiences of GPs working during the COVID-19 pandemic. Methods: A qualitative study was conducted using semi-structured interviews. Using purposive sampling, 15 GPs from South-Eastern Australia were asked to reflect on their experiences during the first year of the COVID-19 pandemic. Interview transcripts underwent thematic analysis. Results: Five main themes were identified: fear of infection; uncertainty and information overload; impacts on the government–GP relationship; impacts on the patient–doctor relationship; and teamwork within practices and among GPs. Conclusions: The 15 GPs interviewed in this study provided valuable insights into their experiences working during the first year of the COVID-19 pandemic. From these insights, four recommendations propose what could be done to help support GPs to respond to a pandemic while continuing to deliver primary health care. Although general practitioners (GPs) have played a crucial role in Australia's COVID-19 pandemic response, few studies have explored the impact of the COVID-19 pandemic on GPs themselves. In this qualitative study, 15 GPs from South-Eastern Australia were asked to reflect on their experiences working during the first year of the COVID-19 pandemic in semi-structured interviews. Their reflections enhance our understanding of the experience of GPs working during the COVID-19 pandemic and may help guide future research and work to support GPs. [ABSTRACT FROM AUTHOR]

Background: Autistic adults experience barriers to accessing health care, such as service provider communication not meeting their needs, healthcare facilities causing sensory discomfort and feeling fear or anxiety regarding their healthcare visit. The Academic Autism Spectrum Partnership in Research and Education (AASPIRE) developed and trialled an online healthcare toolkit to reduce such barriers and improve healthcare interactions between autistic adults and their primary care providers in the United States. This preliminary study aimed to explore experiences of autistic adults using the AASPIRE Healthcare Toolkit in Australia. Methods: Semi-structured interviews were conducted with six autistic adults about their experiences and perceptions of utilising the toolkit in an Australian healthcare setting. Results: Participants identified that the toolkit facilitated their interactions with health professionals by providing structure to appointments, supplementing new knowledge and increasing individual confidence. They also offered suggestions to tailor the toolkit for use in Australia. Conclusions: Future research should seek to explore the experiences of autistic adults using a version of the toolkit adapted for Australian use, as well as exploring the views of health professionals utilising it. Autistic adults often experience barriers to accessing health care and have negative healthcare experiences. We wanted to know if an online healthcare toolkit developed with autistic adults to improve healthcare interactions between them and their primary care providers in the US, could be used in Australia. We interviewed six Australian autistic adults about using the toolkit, with positive feedback. An Australian-adapted healthcare toolkit may potentially improve the healthcare experiences of autistic adults living in Australia. [ABSTRACT FROM AUTHOR]

Long-acting reversible contraceptives (LARC) are the most effective contraceptive methods available in Australia and are effective for between 3 and 8 years. Early LARC removal (<12 months of use) can lead to gaps in contraceptive cover, exposing women to the risk of unplanned pregnancy. This study explored the experiences of doctors working in primary care (GPs and sexual health physicians) when asked to remove LARC earlier than expected. From May to July 2020, 13 doctors in Melbourne, Australia, were interviewed. Overall, participants felt conflicted about early LARC removal requests; participants highlighted the importance of respecting patient autonomy, but many felt that patients should ideally persist with LARC longer. Participants found balancing a desire to respect patients' autonomy with their clinical responsibility challenging. Doctors used reassurance, delaying tactics and treatment of side effects to try and prolong LARC use. However, this balancing act led many doctors to perceive a tension between themselves and their patients when early LARC removal was requested. Incorporating professional education addressing these issues may help primary care providers better anticipate and navigate the tension surrounding early LARC removal consultations and maintain effective doctor–patient relationships. Long-acting reversible contraception (LARC) are the most effective contraceptive methods available, and although most women keep their LARC in for the prescribed length of time, others will request early removal. This study found a perceived tension between doctors and their patients when early LARC removal was requested. Appropriate training and more relevant professional development may help primary care providers better navigate the tension surrounding early LARC removal consultations and maintain effective doctor–patient relationships. [ABSTRACT FROM AUTHOR]

We explored patients' and GPs' perceptions of an alternative payment system, a Patient-Chosen Gap Payment, where a gap fee is determined by the patient based on their perceived value of the service, including the choice to pay nothing. Semi-structured, in-depth interviews held with GPs (n = 10) and patients (n = 10) were audio-recorded, transcribed and analysed for emerging themes. We found three emergent themes: (1) the cost of quality: health care was difficult to value for both GPs and patients; there was belief in universal coverage and the importance of quality, but tradeoffs in quality of care were a common perception; (2) the doctor-patient relationship: patient-centred care was a common goal and perceived as a good measure of quality care and a way for patients to place a value on the service/care; and (3) the business of general practice: participants wanted to see sustainable business models for primary care that incentivised quality of care. A Patient-Chosen Gap Payment (PCGP) funding model could incentivise doctors to provide better care without limiting access to health care. Further research is needed to model real-world application. [ABSTRACT FROM AUTHOR]