To the Editor: My compliments on the issue of the Journal on the survival of general practice (20 July 2009). But something was missing — a patient’s perspective.

I hear from fellow Sydneysiders that they cannot find a general practitioner offering continuity of care. They tell me that:

• All recommended GPs have “closed books”.

• They can’t get an appointment on the day and have to wait until a few days later, unless it’s a “real emergency”.

• At big, “commercial” practices, they seldom see the same GP again — and must tell their story each time.

• Their GP (preferably female) is there some weekdays only.

• They can’t find a GP who does home visits.

• Neither “their” GP, nor any of the others in the practice, is available after hours — they must ring an emergency doctor with no access to their records.

• GPs want them out quickly with a prescription or referral.

• GPs say that, although it’s a simple procedure, it’s better done by a specialist.

• GPs want to start a “care plan”, even if there’s nothing much wrong.

• They’re not happy with attention from the nurse — they want to see the doctor.

And so it goes.

Back in 2006, the Australian Consumers Association, together with advice on choosing a GP, commented:

The relationship you have with your doctor can be one of the most crucial in your life ... A positive ongoing relationship with your GP is extremely valuable, making it all the more important to choose the right one.1

Shouldn’t the MJA open its pages — on an issue which matters so much to them — to patients, to air their concerns? As it would be anecdotal, we would need evidence. A recent article in the BMJ surveyed British attempts at harnessing the views of patients.2 The authors’ opening comments were: “There is now a widespread realisation that patients’ views are not optional but essential to achieving high quality care.” Similarly, Australian patients’ expectations about weight management in general practice were discussed in the Journal in 2006.3

Is general practice’s survival not about adapting to meet patients’ requirements for high quality of service? In special issues devoted to the adaptation of general practice to future change, should not bodies like the Australian Consumers Association and some of the patient support groups, such as Arthritis Australia, be asked to contribute? Perhaps the MJA’s discussion is missing the wood for the trees?