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No end to shortage of doctors

A large crowd gathered at the Carterton Events Centre on Wednesday night to hear how a medical practice intends to address having just two doctors struggling to serve 7000 patients.

The purpose of the open forum held by Carterton Medical Centre [CMC] was to help community members understand the context of ongoing staffing constraints and challenges, and to provide the opportunity for public input.

Self-described “local lad” David Heard told attendees that when he joined the practice 20 years ago, there were three doctors and 4500 patients on their books.

Fast forward two decades, and Heard noted that the typical consultation has become more complex – thanks to factors such as medical advances having increased lifespans, and some patients having 15 different medications and comorbidities – which has led to strains on the system.

A scheduled 15-minute appointment is “woefully inadequate”, but the reality of supply and demand is that more time is “impossible”, Heard said.

“If we are faced with too many issues and lists, it can impact on decision-making and the diagnosis,” he said, and advised booking a double appointment if patients have more than one issue to avoid delays.

Mark Wills – CMC director, and chief executive and managing director of parent company Omni Health – said media reports about the health sector being under pressure are “all true”.

“That’s just the tip of the iceberg,” he said.

“It’s a very challenging environment right now, I have worked in the health sector for over 25 years, and this has been the toughest period in all of that time.”

Although New Zealand has more than 4900 general practitioners [GPs] to serve its population of 5.2 million, that figure is deceptive, he said.

“Unfortunately, the number of fulltime equivalent GPs is actually under 3000,” he said, meaning there are 1800 people on average for every GP.

The most recent Statistics New Zealand data for Carterton said there were 9198 people in the district in 2018.

As such, “We have more demand for services than there has ever been the case … because the population has grown”, Wills said.

“On top of that, we have a public hospital system that is really struggling, and a lot of patients are being pushed back into the community.

“Increased global competition is heating up, and we’re competing in an international market for clinicians.

“This is the toughest we have ever seen it in terms of recruiting people.

“It’s not for lack of trying, I can assure you.”

Sandy Moore, CMC’s practice manager for nearly two decades, said the centre is actively recruiting, but it takes time to fill positions.

“We are doing as much as we possibly can to maintain services to you, our community, as well deal with staff shortages, the risk of burnout, and high demand,” she said.

Moore revealed that the administration team receives about 200 daily calls, as well as meeting and greeting people at the door.

“We are not the only practice experiencing challenges, but you, our patients, can be part of meeting those challenges and assisting us in finding solutions,” she said.

Although CMC’s nurse practitioner is leaving next week, there are two nurses training to be prescribers who will be seeing patients next week, Moore said.

A nurse will start in late May and another in July, meaning the practice will have five nurses in total.

With three healthcare assistants, the total staffing headcount is currently 19, she said.

During a Q and A session, one of the crowd asked about “people who don’t want to see a male GP?”

“We are limited, that’s the reality,” Moore responded, but the practice is “actively looking” for new doctors and can refer patients elsewhere in the interim.

When another attendee asked if “Carterton is the priority” for Omni Health, Wills noted that the primary health care provider also has a practice in Taranaki with 5000 patients on the books and no doctors.

“If we had a doctor, the reality is we would send them there,” he said, while noting that would ultimately be up to the applicant.

The practice has also joined an online recruitment platform and is looking to work with artificial intelligence to streamline services.

During the meeting, CMC representatives offered alternatives in keeping with such global trends as utilising phone and video consultations, and using telehealth providers Practice Plus and Manage My Health.

Creating a community forum for ongoing input and feedback was also canvassed.

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