Our very own Royal Australian College of General Practitioners (RACGP) has rolled out a community awareness program they have dubbed “The Good GP” aimed at highlighting the invaluable role that GPs play in healthcare. Which got me to thinking about the similarities between GPs and Stay-At-Home Mums (SAHMs). Don’t get me wrong, there are no “doctor wars” like there can be with the “mummy wars”, and I have the deepest admiration for my specialist colleagues and their amazing knowledge. I went to medical school with them after all, and count specialist physicians, surgeons, and anaesthetists among my closest friends. No, the problem doesn’t lie with doctors vs doctors, it is in the eyes of the general public and the government. Let me explain why GPs are a bit like SAHMs.
1. The work we do is underrated.
Like SAHMs, it’s assumed that all we do is write scripts and medical certificates if you have a cold and we’re always late because we’re having a cuppa in the tearoom. “Oh, are you just going to be a GP?” I’ve been asked so many times over the years. “You’re not going to be a specialist?” Just a GP? I think. I can suture a wound, counsel a grieving widow, perform an eight-week baby check, screen for cervical cancer, diagnose a rash, reassure a worried mum that her child will recover from their virus, know straight away when I have to send a sick child to hospital, diagnose surgical emergencies, remove foreign bodies, manage an acute asthma attack and stabilise a patient who’s having a heart attack, drain abscesses, and treat all kinds of ailments from acne to depression to osteoporosis. The list is endless. Oh, and I can help my patients prevent chronic disease too. And most people aren’t aware that general practice is considered a specialty in Australia with extra training and high standards expected of our GPs. I should know as I’ve been a proud RACGP examiner for 8 years. Just a GP? It’s like saying “Oh, do you just stay home with your kids?” (cue eye roll)
2. We are undervalued and underpaid.
Unlike SAHMs we do get paid, but our worth has been significantly under-valued for years and things are getting worse. A four-year freeze on Medicare rebates has been announced, which means that by July 2018 Medicare rebates will have been frozen for a total of six years. This comes on the back of years of undervaluation of our services, and GPs had to fight hard to have a proposed further $5 cut to Medicare rebates overturned. Given that we are a highly cost-effective form of healthcare, this is an insult to the service that we provide, and it is expected that we either absorb this cost, which will prove unsustainable for most practices, or pass it on in some way to our patients.
3. We do our work because we love it.
Most GPs I know speak of how much they love being a GP – the continuity of care, the relationships they build, and the variety of their clinical work which always challenges them. GPs feel passionate about caring for their patients – as can be seen by the recent successful campaigns by the RACGP and AMA against the proposed co-payment, which doctors felt strongly about because it would compromise the care of our most vulnerable patients. This video created by the RACGP sums up the life of a GP and the rewarding journey we are on, which takes us through generations of patients. Yet, it can feel like a thankless job much of the time. Like being a SAHM.
4. It’s hard work and it feels neverending.
Like SAHMs, we work hard. We see patients back to back, usually sacrificing on our lunch times (morning tea break? hah!) and there is a lot of unpaid work that goes unseen. Not only do we see an average of four patients an hour, GPs face an hour or two of “paperwork” after the end of the day – finishing consultation notes, writing scripts, making phone calls, arranging urgent specialist appointments for a patient with a serious illness, checking test results. Being a GP is exhausting which is part of the reason I had to take a sabbatical to finish my PhD – I simply cannot keep up the pace, plus finish a full-time PhD, and look after my children and myself.
There’s hope for the future though. The new Minister for Health Sussan Ley has announced a review of the Medicare Benefits system, which will be “clinician-led” which means she wants to talk to doctors. I applaud this and hope that with appropriate consultation, a new and better model of Medicare will emerge, one that rewards quality rather than quantity of service. I also hope that the community awareness campaign by the RACGP will lead to increased community engagement, and that together we can create a better way of providing services to our valued patients. At the moment both GPs and patients are frustrated at the challenges we face – I am well aware that patients are unhappy with lack of affordability and access to GPs for one. I constantly hear of how difficult it can be to get a timely appointment. I hope that new and innovative ways to revamp general practice will come from consultation with the community and other stakeholders, and policy-makers.
What do you love about your GP? What do you think we could be doing better? I’d love to hear from you, and also would love you to contact your local MP if you also feel strongly about the rebate freeze.