More GPs the best medicine for all of us

 

12 October 2021

By Dr Bryan Betty, College Medical Director

Originally published on NZ Herald

Research from a Journal of the American Medical Association internal medicine study out of the United States shows that increasing primary care physicians - general practitioners or GPs in New Zealand - by 10 per 100,000 people will increase life expectancy by 51.5 days. That’s 2.5 times greater than investing in other specialists.

Essentially, the lack of support and investment in general practice is starting to have a profound effect on the health of New Zealanders. How many of you have struggled to find a GP due to closed books? Or not been able to access services without going on a waitlist due to a GP shortage? There is a workforce crisis in this country and we need this issue to be taken seriously.

As the first point of contact for many in the community, GPs see patients with a vast array of health issues. The nature of our role also means we can’t anticipate what each patient will require until they are sitting in front of us. The reality is, over time and as people get older, disease and health problems occur. Whether it be diabetes, heart disease, prostate cancer, acute chest infection, thyroid problems, diverticulitis, inflammatory bowel disease, gallbladder issues, renal stones, high blood pressure, stroke, depression, drug addiction, hepatitis, infertility, bronchiolitis, dermatitis, schizophrenia, or pneumonia - the fact is that people will always need medical treatment.

To give you an idea of what we encounter, this list above shows the conditions I saw in just one day at my GP clinic.

New Zealand’s general practice sector provides care to most of the country, and we do it well. The health of you, our patients, is our priority. However, there are increasing problems and strains, the most concerning being the well-documented shortage of specialist GPs. This is alarming because, without GPs, there would be much more pressure put on our already stretched hospitals. There are around 5,000 specialist general practitioners, across 1000 practices, conducting 14 million consultations per year. That’s about 74 general practitioners per 100,000 patients, compared to 117 GPs per 100,000 in Australia, and 122 per 10,000 in Canada.

To qualify as a general practitioner in New Zealand takes, on average, between 11-14 years. Add to that the results from our Workforce survey showing that around 50 per cent of GPs are considering retirement in the next 10 years, and it’s clear the need to encourage more doctors into general practice is crucial.

Last year, The Royal New Zealand College of General Practitioners carried out a survey of more than 1400 GPs across the country to identify the contributing factors of work burnout. Nearly 31 per cent of the respondents rated themselves as high on the burnout scale, up from 22 per cent in 2018. Not surprisingly, the three main factors identified were the increasing patient needs and complexity, the increase in administrative work and the 15-minute appointment model.

The Government claims it wants to solve the problems inherent in our health system. If this is the case, it could do well to start with a focus on these three areas. For the community medical sector to function as it should, we need many more highly skilled general practitioners coming into this challenging, but highly rewarding vocation. We also need a well-functioning health system that supports our growing scope as well as our health and wellbeing.

Our system will collapse without it.