VICDOC Summer 2023 - Magazine - Page 37
GP SERVICES ARE STRETCHED MORE THAN EVER
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GP services are stretched more than ever
and should be listed as endangered species
in some areas. Many of my colleagues
working in GP clinics in smaller towns
are nearing the end of their careers. They
chose rural medicine forty years ago and
there is no-one to take over those practices.
Those towns are now facing no practice,
an occasional locum, or having to rely on
virtual services, which seem to be the flavour
of the month to fill chasms in healthcare
delivery. Ironically, many clinicians in those
roles are GPs who have been attracted to
the salary structure provided, as opposed
to the challenges of running a GP clinic
and relying on the scraps provided by
our failing Medicare funding structures.
There’s a thought: maybe we should be
looking at guaranteeing an income for GPs
who choose to work in struggling towns?
THE PROLIFERATION OF VIRTUAL CARE
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The proliferation of virtual care, in all
its forms, is the ‘shiny new thing’ that
governments seem to be favouring to fill
gaps in care but are also likely to be creating
a ‘build it, they will come’ model. While
there is significant value in providing remote
advice to residents in aged care facilities
whose only recourse after 5pm is a trip to the
ED, most of the care needed in situations
like these is low-acuity care for patients who
are unable to access a GP for three or four
weeks. Sure, they may be saving a trip to ED,
but its often a trip that wouldn’t happen if
community care was accessible.
While there are many who tout that
working in a virtual service is good for the
clinicians, in that it provides an alternative
to the high stress environment of a busy GP
practice or an overcrowded, under resourced
ED, and therefore improves the individual’s
wellbeing and mental health (something that
I cannot disagree with), it leaves those who
remain on the frontline in dire straits. Less
clinicians working in EDs creates a worse
environment, and more stressful workplace
for those left behind. It’s a downhill spiral.
As more doctors and clinicians choose the
relative comfort of this form of medical care,
the number of clinicians available to assist in
regional and rural areas further declines.
In no way can we pretend that a clinician
on a computer screen can replace a clinician
at the bedside. Most of the virtual care
providers will agree to this sentiment . But
some rural facilities have had to do just that;
They have given up hope of recruiting and
retaining staff and resorted to contracting
virtual care providers to fill the gaps created.
I am acutely aware of the gaps that divide
regional and urban healthcare and what needs
to be done to see better care delivered to those
communities outside city boundaries.
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