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The delivery of care in the community is increasingly seen as vital in terms of patient outcomes, health promotion, and the prevention of illness in society. The primary care practitioner is generally the first point of contact with the healthcare system, and current reforms in primary health care-as well as the dynamic nature of society and social preferences-have seen the roles of general practice and general practitioners in Australia undergo a transformation. Achieving results in health outcomes is going to require the implementation of innovations such as multi-professional primary healthcare teams,1 technological innovations, and procedural reform. The question remains-how are such changes most effectively implemented, and at what stage are we currently in this "reformation"?
Reformation and innovation
Reforms in primary care are, and will continue to be, an important part of the innovations that will produce positive patient outcomes. Population-based approaches in primary care, coupled with greater cross-sector collaboration and consumer participation, have been touted as being able to deliver truly comprehensive primary health care.2 Culturally appropriate and accessible services, funding and staffing structures that allow flexibility of service provision in terms of location, appointment times, and the range of staff providing services are suggested as necessary to support such reforms and allow the successful transformation of primary care services.2 Treatment of patients will need to take into account the patients' needs, culture and preferences, and will necessitate the need for healthcare
professionals to work together and facilitate cross-disciplinary clinical care to achieve a better solution to the patients' problems.3 This includes issues that relate to public interaction with medical practitioners, including "trust" of medical practice and new innovations in health 4 care.
Disciplinary-specific challenges within primary health care are also appearing. In Australia, the need for care of the dying will accelerate in the foreseeable future. Australia's population is ageing, and with this will come a significant expansion in chronic illness and death from frailty and non-malignant disease. This will exacerbate the challenge to provide palliative care for all people who need it, however 25 per cent of Australian general practitioners state they are not willing to provide palliative care.5,6 Worryingly, such unwillingness is suggestive of problems in the infrastructure and resourcing of general practice in Australia, and dictates that further investigation...