I write in reply to a recent article in The Standard (Resident raises concerns, Saturday, June 4, 2022), about access to medical services in Terang.
I am a Terang GP. I pen this sitting in my office on a Sunday, where instead of spending a relaxing weekend with my family, I have come to catch up on paperwork.
Much of my 'to do' list consists of work I would generally make time for during a consultation; however, in order to free up time to see more patients, I have had to defer a lot of this work for later.
Like much of the work of General Practice, it is unseen.
Because of the way Medicare billing works, this necessary administrative work is also unpaid.
I know that it's difficult to get an appointment with a GP.
I know that there's often a long wait to get in, particularly to the GP of your choice.
Sometimes the clinic is unable to fill after hours rosters, and that leaves vulnerable patients in the community uncertain of where to turn.
After hours work, for those not in the know, means being on call for emergencies at the hospital one 24-hour period per week and one weekend per month, Friday morning to Monday morning, plus seeing our regular clinic patients during the day.
This can cause great disruption to those of us with young families as, regardless of where we live, we must stay in Terang while on call.
For this, we receive a nominal allowance of $135.95.
We don't do it for the money.
Lack of access to GP services, increasing complexity of medicine, long waiting times and physician burnout have been discussed extensively in GP circles for some time. We know that patients are frustrated, and we are frustrated too.
From a GP clinic perspective, appointments run longer, patients are sicker, and their presentations are more complex.
I am no longer able to ask patients with a long list of problems to make another appointment in a week or two.
Frustratingly, if I was able to see patients more quickly, I suspect they would be less unwell and, therefore, less complex.
It really is a Catch-22.
Lack of access to GP services, increasing complexity of medicine, long waiting times and physician burnout have been discussed extensively in GP circles for some time.
We know that patients are frustrated, and we are frustrated too.
Rest assured we are aware of the problem.
There's a large systemic component.
General Practice is by far the least well remunerated of the medical specialties, despite long being acknowledged as the most efficient part of our health system.
Partially, I suspect, this is because GPs do so much of their vital work behind the scenes and for free.
Nobody goes into General Practice expecting to make a fortune, which often means medical graduates don't go into General Practice at all.
In medical circles, General Practice isn't seen as being particularly prestigious, either.
We have years of mandatory hospital training amongst specialist colleagues who, frankly, seem to have little idea what we do.
Many of us field questions from friends and family as well.
"Why don't you specialise?" they ask, as if General Practice wasn't a specialty in its own right.
Of course, these issues are only exacerbated by living and working in a rural area.
It has always been difficult to recruit and retain local doctors.
We are a community service that comes with a lot of baggage.
Non-medical partners need to find fulfilling work.
Children need to find childcare, or schools.
Many of us didn't grow up locally and moving to a country town means leaving our support networks behind.
It's hard to make new friends in your 30s when you're working all the time.
Terang is my community. I moved into my new home the day of the St Patrick's Day bushfires and have considered myself a local ever since. But it's been a few hard years.
I remember the fear early in the pandemic.
Unprepared and unprotected, not considered a frontline worker because I'm "just a GP," I remember breastfeeding my infant daughter and wondering if I was getting her sick.
I worried I would get my elderly patients sick.
I watched as those same patients aged rapidly in lockdown, without access to their usual supports, and my heart broke for them daily.
My family is in South Australia, and I didn't see them for over a year and counted myself fortunate - many of my colleagues have family overseas and were cut off for years.
At least they were safe from the high numbers of cases and deaths we were seeing in Victoria.
There were rolling changes in the vaccine schedule with little to no warning for GPs before announcements were made. Patients were angry and scared and had every right to be.
New research was coming out daily, often without the usual peer review process, and it was hard to know what to believe. Somehow, we've found ourselves living in a new normal.
I continue to work hard for my patients and my community.
I do want there to be a public discussion about the impacts of the pandemic on General Practice, its role in the health system in general, and the impacts on patient access.
I want patient access to improve.
However, it's hard not to interpret public comment such as the recent The Standard article as a personal attack on how hard I and all the local GPs are working, particularly as no GPs were approached for a comment before publication.
Please let us be part of the solution in future. We know where the problems are.
GPs are all tired, but we will always continue to do our best for our community.
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