Philippa Stevenson: What do we do if all our GPs retire?

The news has a nasty habit of becoming personal.

The alarm bell sounded on Monday by the College of General Practitioners rang especially loud in my house.

Stressed and declining in number, GPs are ageing faster than their workforce is being replenished, the college warned.

In just five years, more than a third of today's GPs plan to be out of general practice. Most days such stats might have captured the attention for only a brief moment. This day they hung about, replete with meaning. They added up to real loss.

My GP isn't retiring in five years' time: he's hanging up his stethoscope in a week.

Only seven days before I and every other patient who has trundled along to see this man with our pains and worries for 35 years are cast into a great, medical void.

And I thought changing hairdressers or mechanics was traumatic. No wonder one patient's words at the news were: "What the hell do we do now?"

It's deeply comforting to be able to discuss this or that odd physical development with someone who's written every illegible prescription for you since you wore short pants or witches britches.

Now you're grey and prone to sensible shoes there's something oddly reassuring about the fat folder that thumps on to your GP's desk when you stop by. Should more than your hair fade those copious notes could be important - capable of telling much of your life's story when you cannot.

Rightly or wrongly, you feel they - and you - are more likely to be understood by the person who wrote them. Now that person has gone. One minute you're a long history of symptoms turned diagnosed ailments, prescribed remedies and recovery (or not); the next you're a blank page trying to figure out whether it's important to mention to a busy and harassed-looking stranger what, over the years, you've had taken out or added in.

That's what it's like on my side of the waiting room but, according to the GP's college, unless something is done quickly about training and retaining GPs, in 10 years' time we may not have even a busy and harassed stranger to turn to.

My GP's working life reflects much of what the college found in a survey of 2057 members.

Thirty-four per cent of our doctors have trained overseas - the highest percentage of OECD countries.

Mine trained in Britain before putting up his shingle in Hamilton in partnership with another British-trained GP in 1970. Then as now, there was a chronic shortage of doctors and their waiting room was soon full. The next two GPs to join them were also British.

College president Jonathan Fox, who is also from Britain, says the degree to which we depend on overseas-trained doctors makes us vulnerable. "It's a global market and other places can be much more attractive."

Overseas-trained doctors are also at higher risk of having complaints brought against them, often because of cultural misunderstandings.

Certainly, New Zealand's ethnic diversity is far greater than the make-up of GPs. Waiting rooms once stocked almost exclusively by Maori and Pakeha are now a veritable United Nations.

Maori and Pacific Islander numbers are also rising rapidly but they are already under-represented among GPs and scholarships encouraging them into general practice have been halted for next year.

Meanwhile, the job's been made harder.

More bookwork has steadily lengthened GPs' already long working day. Mine estimates he now sees half the number of patients a day he once did.

And general practice lost its cornerstone - maternity care. Although it probably contributed most to broken sleep, it was also one of the nicest sides of practice. Among the daily parade of aches and pains expectant mums are almost guaranteed to be cheerful. Delivering a new baby usually meant delivering a new customer.

Now emergency medical centres tend to cream off the quick and easy work, GPs are making the chronic illness sufferer their forte. It's a more expensive field but Dr Fox believes it's high time we compared the cost of maintaining our car, hair or even fingernails with that for maintaining our health.

It's an unarguable point. So is his case for health worker numbers to be boosted across the board.

"It's not a matter of having more nurses to do things GPs once did. We need more of everybody."

Particularly, we need more homegrown talent. The interest is there. Last year, there were 114 applications for the 55 funded places on the General Practice Education programme. The figures are similar for next year. Oddly, the training places were halved in the mid-90s, exacerbating a well-advanced trend.

I'd like to think that when I next visit my local medical centre I'll be beginning a new, long-term relationship with a GP that will be as satisfactory as the last.

But with the number of golfers set to be boosted by a swag of retiring GPs, I may be better off down the clubrooms.