Pay and conditions. Next question?
It's feeling valued Sam. A feeling many of us haven't got, especially with the horrendous inequities many of us have in pay and conditions. This isn't rocket science.
College has consistently failed to represent General Practice and the issues that it faces. As a consequence many senior GPs are disenchanted and burned out. Why would the younger generation want to face the prospect of being disenchanted and burned out? The comments sections on this site are not filled with comments on how wonderful General Practice is or with encouragement for younger colleagues. Much like overseas sites it it is filled with despair and frustration. This is NOT General Practice simply complaining, it is the reality we face because of inadequate representation and compliance with policies that are destroying what we do. All College has accomplished recently is to add to the burden we face. And what we get from you Sam is more rolling over and playing dead. Unless you are vocal and confrontational you will accomplish nothing. Unless you start saying "No" to Government when the funding and the conditions are unsustainable you will only worsen the situation. This is not "touchy-feely" stuff, this is "Stand-up-and-be-counted" stuff. So far I have not seen any "stand-up-and-be-counted" happening.
Absolutely Bryan. We do not need passivity in these grim times, the sector is in crisis. I can hear Nero fiddling...
As an over 65 year old GP I can look back and see what could have been done and what still can be done to avert the "impending retirement crisis". I certainly prefer longer appointments and fewer patients but one has to be able to charge appropriately or it becomes charity. Anyway, here are my three changes the College should consider.
The number one change that the College could insist on is actually valuing the Fellowship so that there is a real and meaningful career pathway for those considering General Practice. DHBs (including medical staff), ACC, MoH, employers and the general public should be expected to treat Vocationally Registered GPs how they treat other specialists and that includes pay and fees as well as streamlined access to all relevant investigations and secondary care. The "just a GP" concept cannot be easily erased so a name change is essential because currently we are just a "health professional" along with health care assistants, chiropractors and kaiawhina.
The second thing the College should have done was to take politicians to task for constantly claiming GP fees were too high. My wife / Practice Manager tells me it now costs her $150 at the hair salon for a simple "colour and trim" and if I get out of a dentist appointment for less than that I am very lucky. Politicians should have properly targeted funding to need (instead of to VLCA clinics) and address the real reason lower income people can't afford a GP, namely overpriced housing meaning there is no discretionary money after paying their rent or mortgage. Mass building of apartments and "tiny homes" would go a long way to easing this pressure instead of continuing to build unaffordable single houses.
The third and possibly most important mistake was accepting the destruction of traditional General Practice by having virtually all primary funding go through PHOs and continuing to allow these PHOs to represent GPs without mandate. If the non-PHO option was funded properly, particularly for low income individuals (not by stereotype), many GPs would have stayed in NZ and in our specialty, because private practice answerable only to our College and our patients is far more attractive than being part of a collective we have no say in.
I would love to see less patients and have longer appointments. I would also love to work school hours. The problem is that there is a huge amount of work to get done and to make a decent living in General Practice you need to work very hard and the suggested "model of care" above ain't going to work. Is this really the best response we can come up with to the impending crisis in GP? Fund it properly and make it an attractive career choice by improving the work conditions and status of General Practice. I wholeheartedly agree with the above comments!
"School hours" are definitely not what the Health Care Homes model has in mind for us Sarah! Also, with the free fall in GP numbers and plummeting profits, longer appointments are a delusion not even Clozapine would help...
Ultimately the time for asking is over, the coal face wants to see action.
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