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“RING your GP for advice” – it’s a sensible instruction for many health concerns. However, GPs say it’s currently being used as a political disclaimer, and they aren’t being resourced to cope with the demand.
According to Brisbane GP Dr Wendy Burton: “Every time a politician says, ‘ring your GP’, we just groan.
“On 4 January, the day boosters became available at 4 months instead of 5 months, our practice logged 2168 telephone calls in a half-hour period. We didn’t answer them all,” she said.
Sydney GP Dr Linda Mann agreed that the current strategy was unmanageable.
“The idea that general practice can accommodate all the people who’ve got COVID-19, who aren’t in hospital – which is 14 000 people yesterday, every day, on top of what we already do – that’s insulting, it’s demeaning. It means that people no longer think that general practice is anything except the dustbin,” she said.
One concern is that GPs aren’t receiving enough communication from official sources.
When the government started telling low-risk people they could manage their COVID-19 with their GP, Dr Mann found out through the media.
“The idea that if you’re not in hospital and you’ve got COVID-19, just contact your GP; if you want information, just contact your GP; do you want a vaccine, go to your GP. That’s great, but how about you tell me first?” she asked.
Gold Coast GP and Associate Professor at Bond University Dr Natasha Yates said primary care has been left out of the COVID-19 conversation for the past 2 years. As a result, they haven’t been given the resources to cope with the current demand.
“In our community, it’s very much being seen as a hospital-based issue. And it’s meant that there has been very little resourcing of general practice, not just financially but also things like recognising that we also need personal protective equipment and resourcing us with information,” she explained.
When the Omicron variant hit, GPs initially had very little guidance about how to manage this disease within their practices.
“We needed evidence-based pathways/approaches/guidelines. How do we triage patients who have it? How do we work out who to escalate? And then who do we contact? What are the numbers that we call? Which clinicians in the hospital can we get in touch with when we’re really worried about someone?” Dr Yates said.
“That has taken many, many weeks to develop. Which is a shame because we’ve had so much lead time.
“While GPs were busy vaccinating our hearts out, those were the kinds of pathways and logistical decisions that should have been made by the state departments, who were supposedly wanting to support the community in staying away from the hospitals,” she highlighted.
Many GPs believe it’s time for a different approach. They say this current Omicron wave should be declared a disaster, so the public knows it’s not business as usual.
“[Declaring a disaster would] activate some extra resources to help staff, and it’s also a bit of a mindset change,” Dr Yates told InSight+. “Not just for the people working, but also for the population to understand. We’re dealing with a whole other level now,” Dr Yates explained.
Dr Burton agreed.
“I’m working extra hours … and bless my nurses and admin staff. They’re working extra with us because it takes a team to get this job done. But if people would just understand that no, they can’t get an appointment as they usually can. And their usual GP may be more booked out than typical,” she said.
By declaring this a disaster, it would take the pressure off GPs as well.
“I think if they were to call it a disaster, then a whole lot of us can go, it’s not just me. There’s that Australian thing of ‘don’t be a wimp, don’t complain, you knew what you were in for when you signed up’. Nobody signed up for this ultra-marathon,” Dr Burton said.
However, Dr Mann doesn’t think declaring a disaster would make any difference.
“I just don’t like the concept of using emotive language to no purpose,” she said. “It’s not new, it’s a continuation of our experience. I read somewhere that only 15% of graduating doctors now choose general practice as their first choice. Does the community have any idea what is going to happen if people don’t become GPs?” Dr Mann asked.
According to Dr Yates, graduating doctors are driven away from primary care because of a lack of funding.
“If you’re a student looking at a lifetime in a certain career, general practice is so underfunded, it’s not an attractive proposition,” she said.
Dr Mann agreed.
“There was a freeze on how much money we got for a 10-year period, and the amount of money that we’ve been paid since then was an increase of only 28 cents a visit. Wow. 28 cents on $39.10,” she said.
Primary care doctors hope this crisis, regardless of whether it’s officially called a disaster, will be the catalyst for significant change.
“We are constantly at the forefront talking with our patients, that’s what we do. And we care about our communities, we know what’s going on in our communities. We’re not greedy with money for ourselves. We just want money to be able to do our jobs and do it properly,” Dr Yates said.
The message is simple. Unless general practice is funded properly now, there won’t be enough GPs to call in the future.
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I am close to packing in general practice entirely. I am not quite of retirement age, but the cumulative effect of COVID +ve patients, inadequate Medicare funding, a minor proportion of obnoxious patients – and I have pretty much had enough.
So what happened to my previous submission and comments ? Too damning to include. We lack any leaders with integrity. The lies and misinformation is overwhelming and condoned by too many of our colleagues who are tied into their own security when principles are involved. This is the ‘war’ of our generation and we seem blind to it or accepting.?
More censorship ??? even from the MJA ??
The main issue is fear mongering by the health czras and media – most people with covid are not very sick, so it is now entirely appropriate it is managed as a usual viral infection by primary care
Here’s The thing that people should advocate for
In the government recognising the personal sacrifice we are making.
All frontline health care staff who see covid patients in person should have their taxes capped at 20% / or pay no tax as we are fighting their war on covid and risking our life .
Or we can all quit and do telehealth
It is demeaning & insulting. It seems to me that all Healthcare workers are being used like pawns in a large chess game. There is no consideration for the extra hours, stress & cost to Doctors & nurses during the handling of this pandemic.
The statements from our “leaders” to say -go to your GP, or about RATkits costs -everything can’t be free, shows total detachment from the reality we all face.
The repeated statements that our Hospitals & Health Service are in a good state to cope with the pandemic also shows total lack of knowledge of the present state. No politicians have set foot in a hospital or tried to work in full PPE for an hour let alone month after month.
We will have Doctors & nurses burnt-out & resigning producing more shortages than we’ve had before.
Their decisions for handling this pandemic have been irresponsible.
It’s time for the government to provide the extra funding needed during this national disaster
On a recent visit to my GP for non Covid matters I asked what I should do if I became Covid +ve as I have an autoimmune condition. In SA I have a number to call and am triaged for treatment or not. I haven’t tested this as yet and hope not to. The problems of our Federation need to be addressed. At the time of Federation no one could envisage the digital age. Time for health to be Nationalised at the very least for infectious disease management.
We as GP’s are most grateful for our colleagues in the Emergency Departments for the fantastic work they do- however- they, respectfully. do not quite fully comprehend what the average day in the life of a busy GP feels or look like- We have to run a small business on a very fine line financially with top heavy overhead costs and have to finish the job in front of us- we do not have the luxury of working shifts and handing over to the next guy. The buck stops with us. We do not even get as much as an Alcohol wipe for free- so dumping the management of COVD- 19 positive patients on GP’s is reckless, careless and disrespectful in its full glory!
Don’t you love when anonymous starts with all due respect and proceeds to put the knife in. We don’t have government provided ppe readily available, fit tested n95 masks, sick leave if we get sick, facilities for effective separation from green to red zones etc. At times in the epidemic a single case in our clinic would shut us down for two weeks to quarantine . We have to cop it sweet pay our usual costs while unable to perform a service to cover these costs with at time the possibility of being shut down multiple times. While trying to do our normal work. Sensible risk management dictated seeing any possible Covid patient via Telehealth only or if too sick see in the car park or send to hospital. We have all had it tough
A bit of understanding from our hospital based colleagues would also go a long way
With all due respect
with all due respect. having to answer lots of phone calls is nothing compared with the bombardment Emergency departments have faced with loads of patients who say that the GP clinic refuses to see them for their asthma, tonsillitis, ear or sinus infection or cough.
It is worse than abandonment It is flagrant blame shifting.We have been dealt ultimate responsibility as we will be the ones patients contact when things go very wrong.
Time to stop all bulkbilling as per Racgp advice
That will cut demand
The inherent altruism of those who enter general practice and our lack of time and other motivations to stand up for our profession means it will continue to erode. While pharmacists have a strong union and are able to offer a number of gp services, general practice cannot supply simple medicines to add another income stream. We are a little like teachers, undervalued, underpaid. Despite being critical to a flourishing community.
Not just abandoned: the failure of leadership at all levels of government puts the responsibility to lead back in our hands.