Background and objective Characterising the general practice response to the COVID-19 pandemic is important for ongoing policy planning. The objective of this study was to explore challenges, responses and effects of COVID-19 in Australian general practice in the early stages of the pandemic, and to consider variance by geographic location. Methods A national cross-sectional online survey of Australian general practitioners was conducted in April and May 2020, with 572 respondents. Results The COVID-19 pandemic in Australia has resulted in major changes to general practice business models. Most practices have experienced increased workload and reduced income. Discussion Australian general practices have undertaken major innovation and realignment to respond to staff safety and patient care challenges during the COVID-19 pandemic. Increased administration, reduced billable time, managing staffing and pivoting to telehealth service provision have negatively affected practice viability. Major sources of information for general practice are primary care-specific, but many practices turn to colleagues for support and resources. AT THE TIME OF WRITING this article in May 2020, the government, health service and community response to the COVID-19 pandemic in Australia had resulted in an extraordinarily low level of infection and death from SARS-CoV-2. At the end of May 2020, there had been just over 7000 diagnosed infections (282 per million population) and just over 100 deaths in Australia (four per million population), 1 with approximately 1-3 new deaths per week. At the time, this compared favourably with pandemic death rates in some other developed countries, which were more than 100 times higher and rising. Unfortunately, the situation in Australia, and particularly in Victoria, changed markedly during the time this paper was being reviewed and revised in June-August 2020. The successful population health outcomes correlate with enormous economic and social impacts in Australia. Major health service realignment has been required of general practices at the frontline of prevention and early intervention of the COVID-19 response. However, the nature of the general practice response, and any geographical variations, remains poorly described. Using a national online survey of general practitioners (GPs), this exploratory study investigates challenges, responses and effects of the COVID-19 pandemic in Australian general practice. RESEARCH
This article explores the process of combining narrative inquiry and critical reflection as research methodology. Qualitative researchers use narrative approaches to explore the stories of participants and to understand the ways these stories were constructed and positioned. Critical reflection provides a framework for deconstructing the stories and exploring assumptions about knowledge, power and reflexivity. In this PhD research, the narrative approach was underpinned by, and combined with, a critically reflective research approach. As these approaches were amalgamated, the critical narrativist emerged. Principles of critical reflection and narrative scholarship can be intertwined; however, the separate threads may be conceptually and practically separated. This article describes how these modes of inquiry came together and discusses the implicit and explicit nature of the methodological positions. Finally, the author considers the opportunities for being more explicit about combining critical reflection with other research methodological approaches.
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