title: General practitioner preparedness to respond to a medical disaster. Part I: Skills and equipment.
abstract: OBJECTIVE
  Financial constraints are leading to the downgrading or closure of many country hospitals throughout Australia. There is concern that general practitioners (GPs) could become deskilled if they lose access to a local hospital. A recent survey of Victorian rural GPs showed that rural GPs in towns without hospitals had different characteristics and working conditions from those with hospital access and backup. Campbell uncovered an apparent paradox: GPs without hospitals were more likely to have emergencies brought directly to their surgeries, and had more equipment in their surgeries, yet they had significantly lower confidence in emergency skills.
  
  
  METHODS
  A questionnaire was sent to 100 general practitioners in two rural divisions of general practice in Victoria, Australia. They were asked to indicate their confidence in performing 18 emergency procedures. They were also asked whether they had available the necessary equipment.
  
  
  RESULTS
  We have assessed the availability of GP emergency skills and equipment in two rural divisions of general practice--one with, the other without, local hospitals. The division without hospitals scored significantly lower in skill levels. A close correlation was found between skill levels and equipment availability. There has been a significant reduction in skill levels in both divisions over time.
  
  
  CONCLUSIONS
  The skills necessary for the stabilisation of a single patient with a life threatening condition are not dissimilar from those needed to treat such a patient in a multiple victim scenario, although the approach and external pressures may be different. These skills, then, are essential to all general practice. The information sought in this survey would be important in the assessment of GP preparedness for both single-victim and multiple-victim (disaster) emergencies. The results of this study raise doubts as to the ability of at least one division to respond to a disaster.
authors.affiliation: Emerald Medical Centre, Victoria.
authors.forename: G T
authors.initials: GT
authors.lastname: Somers
authors.forename: N
authors.initials: N
authors.lastname: Maxfield
authors.forename: E J
authors.initials: EJ
authors.lastname: Drinkwater
mesh_terms: D001315:Australia; D002983:Clinical Competence; D004189:Disaster Planning; D005194:Family Practice / Q000379:methods*; D005260:Female; D005392:First Aid / Q000295:instrumentation / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012423:Rural Health; D011795:Surveys and Questionnaires