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Invercargill patients travel 40 minutes to Gore or nearly two and a half hours to Dunedin just to see a GP.
As the Southland GP shortage deepens, with at least five current openings at Bluff and Invercargill alone, a worldwide job advertisement for a new practice at Invercargill produced just one applicant from Nepal.
Many of the region’s primary care physicians are nearing retirement and younger physicians do not want the same life as them, which means that general practice will need to change.
As Gore Health Trust CEO Karl Metzler put it: “Our patients and healthcare professionals need to understand the fact that we can’t just trust our GPs.”
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Southland’s GP shortage came to the fore again in December, when the Southern District Board of Health reported that the Southland Hospital emergency department was overrun with patients unable to access doctor’s appointments. header.
It is a problem that affects the entire country, but is particularly pronounced in more rural regions struggling to attract new and young doctors.
Neither the WellSouth primary health organization, nor the Ministry of Health or the Southern District Board of Health have data on the ages of GPs in Southland.
Data released under the Official Information Act revealed that 85 GPs and 10 substitutes were working in Southland (as of November 26) with an average age of 50.7 years.
Metzler said new graduates gravitated toward urban centers that were better suited to some families.
“You recruit a family and you have to offer a package that includes high-level jobs and education,” he said.
There was a perception that rural doctors should be able to “catch babies” and deal with emergencies, but this was wrong, he said, as rural hospitals were shouldering the burden of acute care.
Robyn Edie / Stuff
Invercargill GP Sier Vermunt says that it is difficult for doctors to operate their own practice. Fixed consultation fees make it difficult to pay competitive salaries to attract GPs.
Newer GPs were less interested in owning their own practice, as has traditionally been the case in rural communities, due to the administrative burden.
Gore Health had taken a teamwork approach to handling the problem, Metzler said, employing nurse practitioners and physician assistants from the United States and England to absorb the workload of GPs.
It is also using technology, whenever possible, to speed up processes and allow patients to do things like order repeat prescriptions online.
“We have to be smarter,” he said.
The GP shortage appears to be most acute in Invercargill, where only one of the city’s 13 practices had the capacity to accept new patients.
Only 40 percent of the Southland and Otago populations are enrolled in a general practice, and Metzler said Gore Health was enrolling Invercargill patients.
“But that is not sustainable,” he said.
He added that the practices around Lumsden, Tapanui and Mataura were sufficiently staffed.
Waihopai Health Services Director Dr. Sier Vermunt believed that a major contributor was a lack of government funding, noting that some funding formulas had not changed since 2003, despite an increase in services that doctors were expected to offer.
The consultation fees were set by the Health Ministry, which meant the practice couldn’t raise prices in line with inflation, he said.
“From a business point of view, it is difficult to pay staff and run a company.”
Vermunt said the current healthcare model was pushing more services into mainstream practice, which were already overloaded.
This made working in Southland less attractive to young doctors who wanted a work-life balance, he said.
Vermunt has been working at Invercargill for more than 30 years and noted that the physician shortage was cyclical, occurring approximately every 10 years.
Community health training and funding is needed to stop the cycle, he said.
Victoria Avenue Medical Center’s GP, Dr. Andy Doherty, was 36 when he came to Invercargill in 2007, as the youngest doctor in town.
Only a handful of GPs had come to town after him, he said.
Doherty estimated that 15 to 20 primary care physicians in Invercargill expected to retire in the next five years.
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WellSouth Chief Executive Officer Andrew Swanson-Dobbs said the organization’s healthcare model would help GPs see more patients.
“We have an aging population in terms of GPs. Many are looking into their exit strategies and the increasing burdens placed on them, whether administrative or clinical, take their toll over time, “he said.
WellSouth CEO Andrew Swanson-Dobbs said the health agency, which supports general practices in Southland and Otago, was working on a variety of options to alleviate a physician shortage.
At the top of the list is the deployment of its healthcare home model, providing a more integrated and holistic approach to healthcare, and the creation of new roles as health improvement professionals and health coaches. to guide patients outside of the GP’s 15-minute consultation periods. .
WellSouth was also working with the Southern District Board of Health on a training program that required training physicians to dedicate time to general practices, Swanson-Dobbs said, “to see if they are interested in that part of the profession. “.
Health agencies collaborate in the hospital emergency department to understand how patients access GPs, as well as the patient population and their needs, he said.
