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14 Nov 2017

BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE

As a GP who is there for his patients, providing urgent appointments, aged care visits,  home visits and palliative care, I am fed up with the claims being perpetuated by those pursuing their own agendas under the guise of improving access to health care. Time and time again, we hear that GPs are over-burdened and inaccessible. This is used to argue the case for expanded scopes of practice and healthcare models that fly in the face of medical evidence.

A quick search of online GP appointment booking systems quickly demonstrates the significant number of appointments available on any given today. While patients may not always be able to see the GP of their choice, the vast majority of practices provide patients with an option to see a GP.

The most recent Australian Bureau of Statistics Patient Experience Survey highlights that the proportion of patients who waited longer than they felt acceptable for a GP appointment has decreased, and has been decreasing in recent years, both in metropolitan and rural areas.

In my experience of general practice, practices always keep aside a number of appointments each day for acute cases. In addition, newer doctors to the practice will often have more appointments available as they build their patient lists. Cancelled appointments can be utilised by others who need them and we often squeeze in a patient between appointments.

All that is required is a little communication. Our patients should know that if they need to see us they only have to call to see if we can help them. 

The story that it is too hard to see a GP is being perpetuated by other groups with their own agenda. Some use it to justify overhauling the health workforce while others use it to promote or improve their own business models. Most recently this argument has been propagated in an attempt aimed at circumventing the TGA’s recommended up-scheduling of codeine. 

When it comes to pain management, the evidence is in. Low dose codeine is ineffective for the majority of people and it comes with significant health risks. Acute pain can be better treated with other combination analgesics which remain available over-the-counter (OTC).

Persistent pain should be a signal for patients to see their doctor, not a reason to escalate self-medication with a highly addictive drug. How many OTC purchasers of codeine products truly understand that, once metabolised, they are effectively using morphine. These ineffective medications not only carry the risk of addiction but the risk of harm by over use of their companion analgesics.

Frankly, I find the suggestion that GPs would be burdened by discussing with patients their pain and the best ways to treat or manage it, highly offensive. Reducing access to potentially harmful medications is good for patient care. A GP consultation for patients experiencing strong and persistent pain is the best pathway to a good health outcome.

GPs are busy, but we have seen a significant increase in GP numbers across the county. Access is much improved and our patients need to know that we are there for them, including on those occasions when they need more urgent care. Our politicians need to know this too.

As part of the AMA’s effort to spread this word, the Council of General Practice, at its recent meeting, agreed that the theme for next year’s Family Doctor Week will be ‘Your family doctor: here for you’. It is up to each of us to disseminate this message and to deliver on it.


Published: 14 Nov 2017