GPs lighten load on surgeons

CARYS MONTEATH/The Press

PAINLESS OPERATION: John Smith had a lesion removed from his back by a GP.

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Four thousand more potentially cancerous skin lesions were removed from Canterbury patients last year than in 2008.

Sixty-four GPs have been trained by plastic surgeons to remove the lesions at their own practices rather than take up specialists' time.

The programme is part of the Canterbury District Health Board's focus on care in the community to keep people away from expensive hospital beds.

In the past, patients had to be referred to a hospital specialist, which could take up to six months, and then wait many months for an operation.

With new training introduced in October 2008, GPs can now perform non-complex operations or refer patients to a GP who has been trained.

Dr Graham McGeoch said he was removing up to five skin lesions a week at his Barrington practice in Christchurch.

He had performed some previously, but extra training late last year had boosted his confidence and ability to do more complex procedures.

More patients were now eligible for a health board subsidy to have lesions cut out, while others paid up to $200, significantly less than if done by a specialist, he said.

Plastic surgeons had been frustrated by patients arriving with photos taken by their GP of simple skin lesions that had become more dangerous and complex because of the long waiting time before an operation, he said.

"In the past I would have referred many on to the hospital. I'm now able to assist them."

The complex cases he referred for surgery were being seen faster and were referred back to him for checkups rather than having to visit the hospital a second time.

"There are many areas where, with the right support and having processes working well, that GPs and the community can manage care successfully," McGeoch said.

The difficulty was ensuring the extra workload was matched by extra resources, he said.

"People are going to have to look after themselves more and hospitals just do what they absolutely have to," he said. "We are well aware of it; it's just hard work shifting the system to make it happen."

John Smith had a skin lesion removed by McGeoch on Thursday.

It was two weeks after he consulted his GP about the lesion on his back.

He said the 20-minute operation was painless and simple, and he was back at work within an hour.

"Going into hospital for that is crazy. The health system is under enough pressure without something very minor occurring like this," he said.

"I'm all in favour of the doctors being given that extra education from the surgeons to enable them to do this fundamental work."

- © Fairfax NZ News