Campaign calls for investment in GPs as doctors predict grim future of health
The shortage of GPs is nothing new, but doctors across the country are overworked and they've had enough. Reporter Jennifer Eder gets a glimpse into the future as a national campaign is announced.
If you thought it was hard to get a doctor's appointment now, imagine how difficult it could be in 10 years' time.
The forecast is for more people with more chronic illnesses, but 40 per cent of general practitioners will have retired - maybe more, if current working conditions continue.
A campaign is being launched by the Royal New Zealand College of General Practitioners, with more than 350 doctors nationwide warning the future of primary healthcare is looking dire.
Picton Medical Centre is one of many clinics already suffering - the town's only practice, with six GP positions, has spent nine months trying to replace two GPs.
* GP college launches funding appeal to train more doctors
* GP shortage looming as nearly half have retirement in their sights
* Half a million Kiwis not receiving healthcare because of cost
* Appointments hard to get at short notice as GP shortages grow
Another is planning to leave later this year, and two more are eyeing up retirement.
Practice manager Leeanne Gardiner says there just aren't enough Kiwi graduates applying for GP jobs.
She's had a handful of applications from foreign doctors seeking work through recruitment agencies, which charge hefty fees to practices that hire their clients.
But Gardiner wants to hire Kiwi GPs so she can avoid paying large sums to foreign agencies.
"You haven't really got a choice about who you hire sometimes, you have to fill the position."
In the meantime, she's got two locums - or temporary GPs - working at the practice, but locums are expensive too, she says.
"We are running a business. In an ideal world, it would be lovely to spend half an hour with patients, but we can't."
Further south, near Blenheim, Renwick Medical Centre GP and the Top of the South Rural Alliance chairman Buzz Burrell says becoming a GP is not an attractive option for many medical students.
"Before becoming a GP I did hospital training ... And having seen the world from either side of the fence, I can say that being a GP is a billion times harder than any hospital job. You're expected to be a jack-of-all-trades, you have to take responsibility and make decisions, we do a lot more than the public realise.
"Young doctors, they're staring at these things - the job is hard, you're poorly paid, it requires a business model - they look at all that and go, 'stuff that'."
A general practice has to make money to pay the wages of doctors and administrative staff, alongside other costs, Burrell explains.
"GPs not only have to be incredibly hard-working but they have to run a practice as a business. I don't think people realise how underfunded every general practice is. People assume we're extremely well-funded, but we're not."
Primary health providers, funded by the Ministry of Health, give a set amount of funding to practices for each patient enrolled, so patients pay less for each visit.
But it's not a foolproof system. The amount of funding per patient is calculated based on an average number of visits, so if patients are visiting more than the average, the practice does not make a profit.
Practice managers have to try to balance patient numbers and GP numbers, Burrell says.
"I'm over the moon to have gained our third doctor. But the price I've paid for that is the business is not quite viable. If I take on more patients the business becomes more viable. But the more patients you get, the more overworked you get.
"It's a really dangerous and damaging reputation that general practice has got, that seems to almost justify overworking and underpaying GPs. We genuinely need more funding to start training more doctors, but that's only part of the issue."
GPS SPEAK OUT
Gardiner and Burrell's concerns are echoed by GPs across the country in the GP college's campaign.
A Marlborough doctor writes that the current model of care will not cope with the "tsunami" of patients with chronic diseases that is forecast.
"[A better system] requires more time with patients and more trained staff in order to deliver education, for example, through nurse educators, health coaches, nutritionists, using other models such as group visits and increased use of technology in medicine."
An Auckland doctor says she wonders if she can continue to survive on four or five hours of sleep each night and still do her patients justice.
"I'm actually too tired to think about the wider issues. Its 10.30pm at night and I still have 142 discharge summaries, 80 lab results to look at and insurance and ACC reports that I haven't even been able to think about."
A Northland GP says, "I worry what my job will be like in the future, and whether I will have the stamina and emotional strength to perform it".
WHAT'S THE SOLUTION?
Royal New Zealand College of General Practitioners president Dr Tim Malloy says the comments are heartfelt, consistent and alarming.
"GPs are definitely feeling the pressure of having to deliver more services, with less support. This is a real problem which could have a dire effect on the country if action isn't taken soon," Tim says.
"With more than 40 per cent of the GP workforce planning to retire within the next 10 years, we need to train new GPs now – and that requires more government funding."
The digital postcard campaign later this month will send more than 350 messages from GPs to Health Minister Jonathan Coleman.
It's part of the 'GP – Heart of the Community' project, which aims to raise awareness of the looming GP crisis.
Without a new generation of GPs coming through the ranks, the country faces a critical shortage, making it difficult for patients to get appointments, Malloy says.
"GPs are the gateway to the health system. Neither GPs nor their patients want to see that gate closing."
- The Marlborough Express