Australia is facing a rising cancer
burden: in 2023, about 165,000
new cases were diagnosed (≈ 452 per day) and
51,300 people died from cancer (≈ 140 per day).
While imaging services are widely available, access
to radiologists is uneven — for example, the Northern
Territory has only ~2 active clinical radiologists per 100,000
people compared to ~10–11 per 100,000 in several other
states.
This highlights the critical
role radiologists play in cancer care, and the challenge of ensuring
timely screening and diagnosis for Australians in rural and remote areas.
Radiologists in Screening Programs
National screening programs
highlight just how visible their work is. For instance, take Breast
Screen Australia, where over 1.7 million
women participated in 2020–21, and radiologists helped
identify more than 11,000 cancers. Every single
mammogram in this program is read by at least two radiologists to
maximise accuracy.
Beyond breast screening,
radiologists are also central to lung cancer trials,
where CT scans are being tested in high-risk groups, and they play a
key role in assessing follow-up investigations for bowel and cervical
cancer. Although patients may never meet the radiologist face to face,
their expertise is woven into every stage of Australia’s screening programs.
The Rural Access Challenge
While city residents may take
access to imaging for granted, the picture is very different outside
metropolitan Australia. Only around 12–14%
of radiologists practise in regional and rural
areas. This workforce imbalance creates barriers such as:
Longer waits for
scans to be reported.
Limited access to advanced imaging like MRI or
PET, often requiring long travel.
Fewer interventional radiology
services outside major centres.
These barriers matter. A delayed
scan can mean a delayed diagnosis, which in turn can affect treatment
options and outcomes.
The good news is that technology
is starting to bridge this gap. Teleradiology
services allow specialists in metropolitan centres to report
scans taken in rural hospitals. Mobile imaging units
bring mammography and CT closer to communities. And increasingly, digital appointment booking
and coordination platforms are helping clinics
connect patients with imaging services more efficiently — reducing
bottlenecks and making access smoother, even when specialists are
based far away.
Rural Australians still face
challenges, but these innovations show how smarter systems can help
ensure timely cancer care, regardless of postcode.
Teamwork Behind the Scenes
Radiologists rarely meet patients
face to face, yet their input is central to how cancer care unfolds.
In multidisciplinary team meetings (MDTs), they
present imaging findings alongside oncologists, surgeons, and
pathologists. These discussions often shape the entire treatment plan.
A single scan can carry enormous
weight. It may reveal whether surgery is possible, how extensive it
should be, or if chemotherapy or radiotherapy is the better first
step. Radiologists also help monitor whether treatment is working — or
if plans need to change.
For patients, this
behind-the-scenes teamwork can make the difference between early,
effective intervention and delayed, more complex care.
Looking Ahead: Access, Collaboration, and Better Outcomes
From the first mammogram to
follow-up scans years after treatment, radiologists are silent but
essential partners in the cancer journey. Their expertise ensures
cancers are detected earlier, diagnosed more accurately, and monitored effectively.
For Australians — especially
those in rural and remote areas — access to radiologists isn’t just
a matter of logistics. It can determine how quickly cancer is found,
how effectively it’s treated, and ultimately, the chance of survival.
At the same time, the way
healthcare teams work together is changing. Radiologists are
increasingly looking to connect more directly with GPs and primary
care providers through digital platforms that simplify
appointment booking and streamline referrals. This makes it
easier for clinics to link patients with the right imaging services,
reduce bottlenecks, and ensure results flow quickly back to the
treating team.
Despite this, much of what
happens in those consultations is framed around reproductive needs:
contraception, Pap smears, pregnancy care, or menopause. These remain
essential, but they are not the full story. Women’s health extends far
beyond reproduction, encompassing chronic disease, mental wellbeing,
ageing, and the profound health impacts of violence and trauma.
Rethinking the Lens on Women’s Health
Women’s health should be viewed
as a whole-of-life journey — from adolescence to older age, from
preventive health to mental wellbeing, from chronic disease management
to recovery from trauma.
The National
Women’s Health Strategy 2020–2030 reflects this
perspective, identifying priorities such as healthy ageing, chronic
conditions, mental health, and addressing cardiovascular conditions.
Yet in everyday primary care, many of these remain underexplored. That
gap leaves women at risk of missed diagnoses, delayed treatment, and
poorer long-term outcomes.
Why Primary Care Must Step Up
General practice is uniquely
positioned to shift this paradigm. Every encounter — whether for a flu
shot, contraception review, or blood test — offers an opportunity to
screen, educate, and intervene earlier.
Expanding the scope means:
Detecting
cardiovascular and metabolic risks before they cause harm.
Recognising
overlapping symptoms of stress, fatigue, and mood changes as
potential indicators of mental health concerns.
Creating safe environments to
screen for family and domestic violence.
Supporting women through the
ageing process, not only through reproductive milestones.
This is not about adding extra
workload but about making each encounter count.
Beyond Reproduction: Key Areas of Focus
Healthy ageing, chronic
disease, and mental health are just as vital to women’s health as
fertility or contraception.
Healthy Ageing & Bone Health
Osteoporosis and fall risk increase after menopause, yet
preventive screening often lags. Primary care can integrate
assessments and advice early.
Chronic Disease &
Prevention Cardiovascular disease is the
leading cause of death in Australian women. Regular risk
checks for blood pressure, cholesterol, and diabetes should
be routine in GP care.
Mental Health &
Wellbeing Women experience higher rates of
anxiety and depression. Perinatal mood disorders, if
untreated, affect both mother and child. GPs are often the
first to notice these patterns.
Violence, Trauma
& Abuse With one in three women
experiencing intimate partner violence, trauma-informed
screening and referral can be lifesaving.
Reproductive
Health (Beyond Basics) Contraception, STI
testing, fertility planning, menopause, and sexual function
remain important but must be placed within a broader health
framework.
A Patient’s Journey
Take Sarah, a 45-year-old who
visits her GP for a contraception review. Instead of focusing only on
medication renewal, her doctor notices her blood pressure creeping up,
opens a conversation about mood and home stress, and addresses
menopausal symptoms. Within one consult, Sarah receives preventive
care for hypertension, support for mental health, and a tailored
menopause plan.
A year later, her
cardiovascular risk is managed, her wellbeing supported, and her
quality of life improved. This is women’s health done right — beyond reproduction.
Enablers in the Australian Context
For clinics to embed this broader
approach, the right supports are essential:
Education and training in menopause,
trauma-informed care, and chronic disease in women.
Adequate
funding and rebates that recognise longer
preventive consultations.
Digital tools and prompts
within best practice software to flag preventive checks.
Referral networks linking GPs to psychologists,
allied health, family violence services, and community
resources.
Culturally safe care, designed with and for
Aboriginal and Torres Strait Islander women, culturally diverse
groups, and LGBTIQ+ communities.
One advantage of the digital age
is the rise of platforms and
professional networks that provide continuing education,
practical resources, and collaborative spaces for clinicians across
disciplines. These tools allow busy clinicians to stay updated and
supported, making it easier to bring whole-of-life women’s health into
daily practice.
Final Word
Women’s health is a
lifelong journey. By rethinking the lens in primary care, we can
prevent chronic disease, improve mental wellbeing, reduce
inequities, and ultimately help women live healthier, longer lives.
The strategies and policies
already exist — the task now is to bring them into practice. With the
support of digital platforms and collaborative networks, including
those like RxTro, clinicians can access the education
and tools needed to deliver truly holistic women’s health across the lifespan.
Mental health is one of the most
common concerns presenting in primary care. In fact, research shows
that up to 71%
of GP consultations in Australia involve psychological
issues of some kind. General Practitioners (GPs) are usually
the first point of contact when people seek help, but GPs cannot — and
should not — be expected to manage every aspect of mental health
alone. That’s where psychologists come in.
A shared-care
model, also called collaborative or integrated care,
enables GPs and psychologists to work together in a structured way. It
ensures patients receive timely, effective, and holistic care that
addresses both mental and physical health.
What is Shared-Care in Mental Health?
Shared care refers to
planned, structured collaboration between GPs,
psychologists, and often other professionals like psychiatrists,
social workers, or mental health nurses.
Key features include:
Joint treatment planning.
Clear
role definitions (who prescribes, who delivers therapy, and who
monitors progress).
Ongoing communication
between professionals.
Regular outcome
measurement and treatment adjustment.
Patient-centred care where individual goals guide
treatment.
This model is backed by
extensive international evidence. Meta-analyses
show that collaborative care produces better outcomes for
depression and anxiety than usual care at 6–12 months.
How GPs and Psychologists Work Together
Here’s how collaboration
typically looks in practice:
Detection and Referral
The GP identifies possible
mental health concerns during consultation.
A referral to a
psychologist is made, often under a Mental Health
Treatment Plan (MHTP) through Australia’s Better
Access program.
Assessment and Planning
The psychologist conducts a
detailed psychological assessment.
Together with the GP, they
align on a treatment plan: therapy, medication, or
stepped-care interventions.
Ongoing Therapy and Monitoring
The psychologist provides
evidence-based interventions such as CBT, ACT, or
interpersonal therapy.
The GP may monitor medication, physical
health, or comorbid conditions.
Communication
Psychologists provide written updates or
feedback to the GP about progress.
In integrated clinics, case
reviews or joint sessions may be held.
Escalation or Step-Down
If the patient isn’t
improving, the team may involve a psychiatrist or intensify
therapy.
If the patient recovers, care may step down
to maintenance or GP monitoring.
Evidence for Shared-Care in the Australian Context
Australia has made considerable progress
in integrating mental health care into primary practice, and the
evidence is clear. Approximately 87% of Australians visit a General
Practitioner (GP) annually, with the majority of these consultations
addressing psychological issues. This underscores the crucial role GPs
play in identifying and addressing mental health needs across the population.
One of the main pathways for collaboration is the Better
Access programme, which allows GPs to refer patients to
psychologists under a mental health treatment plan, with Medicare
rebates available to subsidise sessions. In 2022–23, Australians
accessed about 6.43 million
subsidised psychology sessions, a slight decline
from the previous year, showing both the high demand and the
sensitivity of access to policy changes.
Evidence also shows the value of shared care in rural
settings, where access can be more difficult. For
example, a GP clinic trial involving psychologists, mental health
nurses, and visiting psychiatrists demonstrated improved continuity of
care and better access for people with mood disorders, substance use
issues, and psychotic illnesses. Such models illustrate the importance
of multidisciplinary collaboration where specialist services are sparse.
Finally, Australia has embraced stepped care
approaches in primary mental health. This means that
patients can access low-intensity interventions first, such as guided
self-help or brief therapy, with more intensive treatment available as
needs escalate. The stepped care model optimises resource utilisation
while maintaining treatment responsiveness to individual needs.
Benefits of the Shared-Care Model
Shared care between GPs and psychologists offers significant
advantages for both patients and clinicians. Coordinated care
consistently improves patient outcomes, especially for depression and
anxiety disorders, according to studies. By working together, GPs and
psychologists can identify issues earlier, ensure timely treatment,
and reduce the risk of conditions becoming chronic. This approach
recognises the close link between physical and mental health care and
supports their integration.
For patients, shared care also means better access to
services, especially when psychologists are co-located within
primary care clinics or available via referral pathways like
Medicare's Better Access programme. Continuity of care is enhanced,
stigma is reduced, and people feel supported by a team rather than
having to navigate the system on their own. For GPs, working in
partnership with psychologists provides valuable support, helping them
feel less isolated when managing complex mental health cases.
Together, these benefits contribute to higher levels of
patient satisfaction and more efficient use of healthcare resources.
Challenges in the Australian System
Despite its promise, shared care is not without obstacles in
Australia. A major barrier is funding. While the
Better Access programme provides rebates for psychological services,
the gap between rebate levels and actual session costs often leaves
patients with significant out-of-pocket expenses. Policy shifts — such
as the reduction in subsidised sessions after COVID-19 — have also
created uncertainty and criticism from clinicians and consumers alike.
Workforce shortages are another concern. Psychologists are in
high demand across the country, with shortages most acute in
rural and remote areas. The result creates
inequities in access, particularly for Aboriginal and Torres Strait
Islander communities and low-income groups. On top of this,
coordination and communication challenges
persist: different record-keeping systems, unclear role boundaries,
and limited feedback loops can reduce the effectiveness of
collaboration. Finally, scaling up integrated models requires not
only more staff and resources but also cultural shifts within
organisations to foster trust and teamwork.
Why Shared-Care Matters for Mental Health
The shared-care model between GPs and psychologists is not just
theory — it is already being applied across Australia, from
metropolitan clinics to rural GP practices. Programmes like Better
Access have made psychological care more available, but system
pressures — workforce shortages, policy changes, and inequities —
remain barriers.
For patients, the advantages are clear: earlier help, better
outcomes, and more coordinated care. For health professionals,
collaboration means support, shared responsibility, and the ability to
deliver more holistic, person-centred care.
As Australia continues to reform its mental health system,
strengthening shared-care models is one of the most promising ways forward.
By RxTro
22/9/25 11:57
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