The older patient, the general practitioner and the trainee : patients' attitudes and implications for training

What is already known in this area
⦁ Population ageing is a global phenomenon which will significantly affect GP caseloads and the
requirements of GP training.
⦁ Older and chronically ill patients appear less likely to consult a GP trainee, affecting GP trainees’ exposure
to chronic disease management.

What this work adds
⦁ A minority of older patients in this study were comfortable with trainee chronic/complex care.
⦁ Female gender, length of time with current GP and chronic illness were all negatively associated with
attitudes to trainee chronic/complex care.
⦁ Older patients were more comfortable with trainee chronic/complex care in a scenario where contact with
their regular GP was maintained.
⦁ The results suggest strategies to maintain interpersonal continuity with older patients’ GPs may
improve acceptance of trainee chronic/complex care and enhance trainee exposure to chronic disease
management.

Suggestions for future research
⦁ Interventions aimed at maintaining interpersonal continuity in training practices should be assessed to
investigate whether the strategies result in improved outcomes in patient acceptance and to assess further
outcomes such as patient safety, clinical parameters, trainee competency and practice chronic disease
management capacity – cluster-randomised controlled trials would be ideal.
⦁ Acceptability of such strategies by training practices needs to be assessed and international comparative
research is recommended to allow comment on country-specific applications.

© 2012 Radcliffe Publishing Limited