How did GP end up like this?
COVID has been very difficult for most people in the world.
But it has extracted a very heavy toll on General Practice.
Endless changes.
Endless difficulties.
Sometimes there was a complete breakdown of systems that previously had worked as borders closed and Governments took extreme measures.
Sure there was a silver lining - we finally got billable telehealth…
But COVID caused so many problems because of politicians on one hand - and on the other?
15+ years of neglect of General Practice…
In that time GP has changed.
The amount of responsibility, complexity and challenges have all got a lot harder.
And despite this, you will be expected to receive a percentage of the Medicare rebate our specialist colleagues enjoy?
It is little wonder that less than 20% of medical students would now select general practice as a career option.
They know.
So what forces have driven these changes to our work?
Let's have a quick look…
- Computerisation
Computers are great. They allow us to do a lot with a little.
But they have also led to a massive increase in data coming into every GP’s world, every day.
Amongst the deluge of information are many small details that must be picked up or you face a significant risk of unwanted problems.
Unfortunately, these important details are rarely clearly identified and lost in the sheer volume of data we now face.
It means you must stay on top of the data flow at all times AND pay careful attention throughout the incoming pathology, radiology, specialists letters, WorkCover and discharge summaries…
- Patient Knowledge
The arrival of google has meant that “everyone” is now a doctor.
You’ve seen these patients.
I’ve seen these patients.
Gone are the days when GPs had significantly more knowledge than our patients - now even my 8-year-old daughter can type in her symptoms and diagnose herself.
This means we are often trying to reeducate patients instead of diagnosing and treating them.
- Medicare
How could we not mention Medicare as a cause of increasing problems in GP?
The death of standard consultation medicare rebates has meant most GP practices are run chasing high paying medicare item numbers.
Whether these are in the patient’s interest or have any significant improvement in patient care is debatable…
But one thing is for sure - if you are not playing the “Medicare Game” then either you are private billing your time or you are going broke.
This brings us to one of my favourite difficulties… :(
- Time control
It is no secret that GPs are notorious for running late.
Are we all just terrible time managers?
Somehow we had the ability to get through medical school (and even get into medical school) complete internship and residency programs and pass difficult fellowship exams and yet…
All of us have terrible time management?
Or could it be that time-based appointments rarely match the actual time it takes to see a patient?
Central chest pain?
Suicidal teenager?
Drug and alcohol problems?
Domestic violence?
Do all these fit into nice 15 minutes appointments?
And that’s before your patient brings out their “one more thing” at 14 (or 18) minutes into the consult…
It would seem we are trapped in a game of many difficulties, high risk and relatively low pay for the amount of stress, worry and effort it takes to be a good GP.
