Table 2

Gruen et al's domains matched to the RACGP case study

Domains of obligation and aspiration

Obligation

Aspiration

Individual high quality patient care

Access to care

Direct socioeconomic influences

Broad and global socioeconomic influences

Examples of actions where broad agreement exists

Ensure GP trainees exposed to work in disadvantaged communities

Ensure training includes opportunities to assess community need including local practice responses to unmet need

Include socio-economic context more prominently in the problem based curriculum

Advocate for increased support for training practices in areas of disadvantage

Formation of an intercollegiate group and a group within WONCA(World Organization of National Colleges and Academies of Family Medicine) to advocate on the link between socioeconomic disadvantage and ill-health

Examples of actions where disagreement exists

Mandating exposure to work in disadvantaged communities

Develop standards on equity of reach of quality measures of clinical care within the known practice population

Advocate for practices to address financial barriers to accessing care

Practices to assess unmet need in their area as a part of accreditation

Learning plans to be mandatory and linked to identified community need

Bold type represent Gruen's areas of professional obligation where consensus exists for action.

Furler et al. BMC Medicine 2007 5:23   doi:10.1186/1741-7015-5-23