Another wave of Covid-19 could be on its way with a new Omicron subvariant seeing case numbers back on the rise. Video / NZ Herald / Ben Cummins
OPINION
The average wait time to see your GP in New Zealand is close to three weeks. There are many short-term reasons for this.
The long-term reason, which is set to get worse, is the low number of trained GPs.
Medical student numbers are lower than in many other first-worldcountries, they have little opportunity to train outside of hospitals, and early career doctors are not encouraged to work in general practice. During the 1990s, we trained fewer than 50 specialist general practitioners and trainees of today must take a leap of faith to work outside their familiar hospital environment.
General practice is the best job in the world. It's complex, always interesting and it's never the same day twice. In the last two years, practices have increasingly adapted and been innovative to meet the needs of their patients.
My practice now has a funded social worker, more nurses (one training to be a nurse practitioner), a clinical assistant to help with paperwork, a nutritionist, a counsellor, and we're running whānau nights, group training sessions and triaging patients.
What we don't have is another doctor, which is what we desperately need.
Our practice looks after between 3500-5000 patients. Many of our patients have multiple health conditions as a result of their poor housing, lack of work, life circumstances, age, or other illnesses. Each doctor has 2000 patients to care for.
My nursing team is doing all it can to add to the medical services provided but it doesn't change the burden of disease and the medical needs of people who expect to see a doctor with the expertise to deal with their level of complex disease.
Their doctor is the person who is extensively trained in every nuance of every disease, prescribing complex interacting medications for multiple conditions in the same person, differentiating and diagnosing conditions from a vast array of symptoms, and efficiently, and cost-effectively investigating and treating them.
The Royal New Zealand College of General Practitioners recently published a commissioned work about the workforce and the cost-effectiveness to the health system of general practitioners. Independent entities overseas such as The King's Fund have done the same.
The magical thinking is that our researched and evidenced documents could not possibly be true, and it's okay to continue down the road of replacement rather than a significant increase in the specialised medical professionals working in our communities.
Samantha Murton. Photo / Supplied
We have a health reform under way that was predicated on transforming primary and community care which means strengthening the delivery of complex medical care in the community. I would like to see some serious steps taken to change the number of medical graduates coming to work in the community. I would like to see serious consideration to supporting other health professionals working in general practice, but not at the expense of providing complex medical care in the community close to the patient home.
People may ask where we start but I liken it to Transmission Gully in Wellington, a piece of road that has been talked about, anticipated, and delayed for decades. One day, someone was brave enough to say, "let's turn over that first piece of ground and get this thing going". Today, I drive along a beautiful piece of road that was a long time coming but it has eased the congestion, connected communities, restored others to peace and solitude, and feels like hope fulfilled.
In 10 years' time, I'd like to say similar things about medical care in the community; that it's beautifully engineered, gives a sense of freedom and future to all communities, and that we have a strong base for medical care in the community.
I'd like to see some bravery to do the right thing for community medicine alongside all the other health care needs that have to be dealt with.
