Research productivity in Australian general practice: what has changed since the 1990s?

Deborah A Askew, Philip J Schluter and Jane M Gunn
Med J Aust 2008; 189 (2): 103-104. || doi: 10.5694/j.1326-5377.2008.tb01931.x
Published online: 21 July 2008

The Primary Health Care Research, Evaluation and Development (PHCRED) Strategy aims to improve Australia’s output of high-quality research from primary care. We compared publication rates from general practice, medicine and surgery for the period 2000–2007, and found that general practice publications increased since 1990–1999 from 1.0 to 3.0 publications per 1000 general practitioners per year. However, general practice publication rates have plateaued since 2000, and represent only 2%–5% of the equivalent rates for medicine and surgery. This finding suggests that more time and sustained investment in PHCRED are essential to see tangible outputs from funded research in general practice.


The annual general practice research publication rate has trebled since the PHCRED Strategy was introduced, but remains very low compared with medicine and surgery, and is incommensurate with the level of clinical activity in general practice.

Despite considerable investment in building research capacity in general practice, its level of research output continues to be much lower than that of other disciplines. This can be partly explained by the very small number of GPs on government salaries (2%) compared with physicians and surgeons (56% and 26%, respectively).3 GPs working in a fee-for-service environment lose revenue if they take time away from direct patient care, which is a disincentive for conducting research. This is not the case for their salaried colleagues, for whom research is often an expected component of their work. Could this be replicated in general practice?

Two components of the PHCRED Strategy (the Research Capacity Building Initiative and the Researcher Development Program) have largely focused on training novice researchers (from all fields within the extensive primary care workforce) and funding small, short-term projects that are unlikely to produce many publications. In contrast, the PHCRED Fellowships, Scholarships, and investigator- and priority-driven clinical research project grants are long-term investments with lengthy timelines for completion and publication of outcomes. Our inability to identify any real increase in the number of general practice publications suggests the level of investment is insufficient and more time is needed to see funded activity translate into tangible research output.

As with the earlier stocktake,2 our approach has important limitations. The search strategy was not specific to research articles, it did not identify publications by general practice researchers whose institutional affiliation does not include the words “general practice”, and it identified only first authors, ignoring general practice researchers collaborating with other disciplines and those outside Australia. Additionally, current and accurate workforce data are not available, requiring us to use different sources to estimate workforce sizes. Nevertheless, our approach is quick, easily replicable and produces an indicative comparison of general practice research productivity over time and with other disciplines. The large disparity we found in relative publication rates is unlikely to disappear with a more rigorous assessment.

Importantly, although research productivity is an indicator of research capacity, it is not the only indicator, and it does not provide information on the quality of research. The PHCRED Strategy should not be assessed solely on the number of publications produced, but also on other indicators of research capacity, including the number of research grants applied for and funded, evidence of research participation, and involvement in research training.

Sustained and targeted investment is needed to develop a sustainable primary care research workforce, if general practice is to provide high-quality, evidence-based care to fulfil its role as the cornerstone of the Australian health care system.

Received 21 April 2008, accepted 11 June 2008

  • Deborah A Askew1
  • Philip J Schluter2
  • Jane M Gunn3

  • 1 Discipline of General Practice, School of Medicine, University of Queensland, Brisbane, QLD.
  • 2 Faculty of Health and Environmental Sciences, AUT University, Auckland, NZ.
  • 3 Department of General Practice, University of Melbourne, Melbourne, VIC.


Competing interests:

None identified.

  • 1. Australian Government Department of Health and Ageing. Primary Health Care Research, Evaluation and Development Strategy. Phase 2 (2006–2009) Strategic Plan. Canberra: Commonwealth of Australia, 2005. %202006-2009.pdf (accessed Feb 2008).
  • 2. Askew DA, Glasziou PP, Del Mar CB. Research output of Australian general practice: a comparison with medicine, surgery and public health. Med J Aust 2001; 175: 77-80.
  • 3. Gray P. The mystery of GP research output [letter]? Med J Aust 2001; 175: 667. <MJA full text>


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