Survey results raise concern for the health and sustainability of general practice

Two recent surveys from The Royal New Zealand College of General Practitioners have signalled real concern about an increase in GP burnout, the number of GPs intending to retire, and the sustainability of the sector.

The College runs its Workforce Survey biennially and when preliminary results of the latest survey showed an increase in burnout amongst its members (31 percent in 2020 compared to 22 percent in 2016), they acted. A second survey specifically covering burnout, and completed by 1495 GPs across New Zealand, clarified the causes into three main areas:

1. Patient complexity has increased because GPs are seeing more patients presenting with mental health issues, and, because more people are now elderly, many have more complex needs. Mental health issues in New Zealand are significant (and very important) and primarily addressed in the community, mostly through a person’s GP. In 2019 the College found that 30 percent of GP consults have a mental health component.

2. The 15-minute appointment model - a model that is 30 years old and outdated, doesn’t work for patients with complex mental health conditions. However, the 15-minute appointment model is the framework for how GPs are funded so this needs urgent Government intervention to change.

3. The paperwork is a relentless mountain - paperwork and tasks like email need to be completed outside consultation time. That includes referrals, tests, and screening results. GPs are spending an additional two hours a day on patient follow up work.

These issues are intensified when there are not enough GPs to do the work required. Some GPs are leaving the profession because of burnout, and it’s increasingly hard to get overseas-trained doctors into the country because Immigration New Zealand’s visa exemption period for essential workers, like doctors, are so short-term.

College President Dr Samantha Murton says, "Our membership of 5,500 GPs and rural hospital doctors provide 96 percent of New Zealand’s frontline care but they’re increasingly struggling with how to do that, while also keeping themselves well.

"The issues of the general practice sector are complicated, but they’re not impossible, which is why we’re speaking out - to advocate for immediate as well as longer-term action that will make a measurable difference to the health of New Zealanders, and the wellbeing of our GP community.

"GPs are highly-trained specialists and they’re highly empathetic people who want to do the best for their patients; they deserve to be able to do that without sacrificing their wellbeing," she says.

"It takes at least 11 years to train as a specialist GP and I know of people who are walking away because they can’t continue to practice effectively and that’s staggering but also incredibly concerning for the future of New Zealand’s community health care," says Dr Murton.

"General practice is a diverse, rewarding career that makes a visible impact on people and their communities, but it needs to be a job that people can do safely."

Despite the difficulties of the profession, more than half of GPs (54 percent) and 80 percent of rural hospital doctors rated themselves as likely to recommend a career in their field.