Photo: 123rf
The super-specialists of the medical profession say it's time they were treated like the vital cogs of New Zealand's health system that they are.
Our family doctors are the super-specialists of the medical profession and it is time they were treated like that, says New Zealand healthcare expert Robin Gauld.
They are the heart of our primary care, probably the biggest brains of our medical profession, but they are undervalued and in crisis, says Professor Gauld of Bond University's business school in Queensland.
Gauld says GPs are not well rated by our medical school and students don't aspire to work in general practice as much as they do in specialist positions. That doesn't help with recruitment of new doctors to work in communities.
"It's a pretty demanding and high risk profession and philosophically there is an argument that general practice should be promoted within medical schools as the super speciality and if you really want to aspire to the highest status in medicine you should be a GP.
"At the moment it's often seen as the lower level work, that the super status is being a cardiac surgeon. That's a really important profession but if all of our doctors are aspiring to a speciality then you're actually undermining the very idea of a strong primary care system."
He wants a shift in thinking at the highest policy levels as a way of addressing the dire shortage in GPs.
The crisis is nothing new but "things are becoming more extreme", he says.
"This term (crisis) has been used for a very, very, very long time.
"It relates to the workforce, the sustainability of the general practice workforce in particular, the sustainability of the business model, where the income comes from, the expenditure and the structure of how the work is done, the 15-minute consultations."
GPs say the 15-minute consult is one of the many parts of their care that isn't working and the announcement of an extra 100 placements for overseas doctors won't be enough to ease the long wait times.
Gauld says the difficulties of keeping to 15 minutes per patient time are exacerbated by growing numbers of patients with "multi morbidities" or multiple chronic diseases.
Fixing it won't be easy but the government should start by doubling the allocation to primary care to 10 percent of the entire healthcare budget, he says.
Chair of GPs College Dr Samantha Murton says that would bring it into line with similar countries.
She tells The Detail that GPs' facetime with patients is only part of their work and the way they are funded needs a shakeup. GPs and practice nurses also want pay parity with their hospital peers.
"There needs to be multiple changes because this has been an incremental devolution of the service over many many years and in many parts," Murton says.
That is backed by a report out yesterday from the think tank New Zealand Initiative called The Heart of Healthcare, focused on GPs. It points to funding gaps, workforce attrition, fragmented IT systems and outdated healthcare models.
The report makes several recommendations that match up with Gould and Murton's views.
"Without fundamental system-wide changes," it says, "stopgap measures will only delay an inevitable deeper crisis in New Zealand's primary healthcare system."
Check out how to listen to and follow The Detail here.
You can also stay up-to-date by liking us on Facebook or following us on Twitter.
