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GPs leading holistic veteran care

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GPs are the centre of the wheel in the management of a patient.”
– Dr Phil Parker, Consultant GP for the Anzac Centre

Dr Phil Parker spent 28 years with the Australian Army and now works as a GP in inner Brisbane, so he is well placed to understand the importance of GPs in supporting the health of veterans. He deployed to Afghanistan as the Senior Medical Officer in the province of Uruzgan and coordinated Coalition forces’ medical care and mentored senior Afghan military, police and civilian health staff.

Since leaving the Army, he has been serving as a community GP in private practice. His military experience and knowledge have seen him take up roles associated with veterans’ health, including education to other health providers, such as the delivery of Australia-wide PTSD workshops to primary health providers, including GPs.

“I never intended to become specialised in veterans’ health. Over the years since I left the Defence Force, however, I have accumulated an ever-increasing number of veteran patients who are looking for a GP who understands the health issues that they are dealing with, both physically and mentally,” says Phil.

“There are many GPs who are doing the best that they can to support veterans’ health, but conditions like PTSD are not easy to manage. I would like to see more GPs understand the importance of their role as the coordinator of the patient’s care. This coordination involves a multi-disciplinary team approach with good communication between the various health providers. It is important that GPs facilitate best practice treatment and seek help and support for complex and difficult cases.”

“It is never enough for a GP to refer a veteran with PTSD to a psychiatrist and feel that their job is done. The psychiatrist is only one member of what should be a wider treating team. The GP also has responsibilities which include psychological referral, assessment and management of comorbid conditions, lifestyle behaviours, family support, and sleep issues. The approach should be much more holistic.”

Phil highlights a case of a veteran who wasn’t receiving the best available treatment and support. He was getting occasional psychiatry support which was mostly centred on medication reviews and basic counselling.

“At the time I saw him he was suicidal and distant from his family. We changed psychologists to one who initiated trauma-focussed therapies, got his family involved in his care, and encouraged regular GP follow-up,” says Phil.

“He now gets reviewed once a month and is doing well. He’s engaged with his wife and children, spends time helping at the school, exercises regularly, and no longer has suicidal thoughts. He now displays greater resilience and insight, recognising when his mental health is declining, and understanding how to manage these periods and what to do if he needs help.”

“GPs can underestimate the value they provide in the long-term care of younger and older veterans. They uphold an important role as the centre of the wheel for the clinical care of these patients and should also understand that support is available for more complex cases.”