GP shortage as medical centres struggle to attract staff
By Emily Norman
General practice doctors are spread thinly in Wairarapa, with up to 1861 enrolled patients each.
The average patient load in New Zealand sits at 1326 patients per fulltime GP, according to figures supplied by the Royal New Zealand College of General Practitioners (RNZCGP).
Each of Wairarapa’s seven medical centres surpasses this average with patient loads ranging from 1625 to 1861 per fulltime doctor.
But upskilled nurses and small-town patient care is trumping this challenge, according to practice managers in the region.
Featherston Medical Centre practice manager Aruni Dias said last week they had only two doctors caring for about 3900 patients, which was “just way too high”.
This week, they increased their GP capacity to three doctors, working four days a week – which works out to be 2.4 fulltime equivalents.
“I wouldn’t say the pressure is off – Dr Hilary Ryan has come on board to ease a significant capacity issue that we already had,” Mrs Dias said.
“There will always be a need for more doctors, and really experienced doctors to work in a rural setting.”
The situation in Wairarapa embodies the nationwide challenge to recruit doctors to rural general practices, and is made worse by a large portion of Wairarapa GPs sitting on the brink of retirement.
A 2016 RNZCGP workforce survey revealed 47 percent of Wairarapa GPs intended to retire within the next five years, with a similar proportion of the workforce aged over 55.
Masterton Medical Clinic Director Tony Becker said with the retirement of some of their older GPs and with some doctors moving out of the area, they have had to deal with the “difficult issue of attracting and retaining GPs in Masterton”.
“This is a growing problem both locally and nationally as well,” he said.
“Our practice is similar to other rural general practices in finding it difficult to attract the new generation of GPs.
“While many of the younger doctors are interested in locuming in a rural general practice, most move on after a short period.”
Masterton Medical is the largest health centre in Wairarapa, with about 22,000 enrolled patients.
They employ 18 doctors who make up 12 fulltime GPs.
Mr Becker said the centre had been fortunate in attracting some “high quality” doctors to work permanently in Masterton, but the practice was also looking at adapting some different methods of patient care.
These included having a few GPs and several nurses sharing the care of a group of patients, rather than the traditional method of patient care being provided by one GP alone.
Patients are also seen by nurses prior to being seen by the doctor.
These nurses are being upskilled, and many are able to provide high level care in diabetes, respiratory disease, renal disease, and aged care.
Martinborough Medical Centre have also embraced the skillset of their nurses, according to practice manager Pam Shackleton.
“Because [Martinborough] is so much further away from the hospital it is sometimes hard to get doctors to come to the practice, as well as with the national shortage.
“One of the things we’ve done is we have upskilled our nurses on some chronic conditions like diabetes, respiratory, gout, so that they can look after some of our patients who have quite a few chronic conditions.
“They keep them on track and keep them stable.”
Martinborough Medical Centre has a patient base of about 2500, and employs one fulltime GP, one that works two days a week, a nurse practitioner, and two full-time equivalent nurses.
Carterton Medical Centre practice manager Sandra Moore said four GPs were employed there – making up 3.5 full-time equivalents – and two nurse practitioners who were “an asset to the community”.
A staff member at Kuripuni Medical Centre said no one was available for comment.
A region-wide issue
Ratio of fulltime GPs to number of enrolled patients
Carterton Medical Centre (1:1861)
Featherston Medical Centre (1:1625)
Greytown Medical Centre (1:1634)
Kuripuni Medical Centre* (1:1849)
Martinborough Medical Centre (1:1796)
Masterton Medical (1:1850)
Whaiora (1:1848)
*Ministry of Health figures.
