Sick of be­ing a doc­tor

The stress on over-worked hospi­tal medics and GPs is push­ing them out of the in­dus­try, says Áilín Quin­lan

Irish Examiner - Feelgood - - Cover Story -

even a ba­sic chest x-ray, and this is a huge stres­sor,” he says.

“And there’s no back-up from the hospi­tal sys­tem.”

It’s no sur­prise, then, that so many young GPs are em­i­grat­ing: a sur­vey pub­lished by the Ir­ish Col­lege of Gen­eral Prac­ti­tion­ers, in late 2017, showed that al­most one in five of re­cently grad­u­ated GPs had al­ready em­i­grated, while one in three of those cur­rently in train­ing were con­sid­er­ing work­ing abroad.

“There is plenty of work for GPs in Ire­land, but a lot of my coun­ter­parts have de­cided to emi­grate, be­cause the work­load is be­com­ing in­creas­ingly dif­fi­cult,” says Kieran, adding that the 38% cut in the in­come stream from med­i­cal-card pa­tients is an­other ma­jor dis­in­cen­tive for doc­tors con­sid­er­ing a community-based med­i­cal ca­reer.

In con­trast, he says, in Aus­tralia or Canada, GPs “can get all the back-up and di­ag­nos­tics you want, plus the pay is bet­ter — a ca­reer as a GP is now a very unattrac­tive pro­fes­sion in Ire­land.”

An­other GP trainee, who did not wish to be iden­ti­fied, says “As a GP, you know that a per­son needs to see a cer­tain spe­cial­ist or get a cer­tain in­ves­ti­ga­tion, but you also know that that in­ves­ti­ga­tion or that ac­cess to a con­sul­tant could take a year or so down the line.

“That’s a source of stress, be­cause when this kind of thing is routine, you end up with a whole co­hort of peo­ple whom you know need fur­ther in­ves­ti­ga­tion or spe­cial­ist re­view, but the ac­cess to th­ese fa­cil­i­ties is not timely — for ex­am­ple, in the case of hip re­place­ments or cataract surgery.

“There’s a huge gap be­tween what is needed and avail­able re­sources.”

Be­cause of the everd­win­dling num­ber of GPs — the Na­tional As­so­ci­a­tion of GPs has warned that the num­ber of GPs in the coun­try has fallen far be­low in­ter­na­tional best prac­tice — pa­tients are now ex­pe­ri­enc­ing in­creas­ing dif­fi­culty in even get­ting a GP ap­point­ment, he says. And when they do get to see a doc­tor, they have less time in the con­sul­ta­tion than pre­vi­ously, be­cause of the pres­sure of numbers.

There is a “huge” is­sue with burnout among doc­tors, warns Dr Mark Rowe, a GP of 23 years, life­style medicine ex­pert, and au­thor of A Pre­scrip­tion for Hap­pi­ness. He points to re­search in the Jour­nal of the Amer­i­can

Med­i­cal As­so­ci­a­tion, which shows that about 50% of physi­cians were ex­pe­ri­enc­ing symp­toms of burnout, he says.

“Car­ing is wear­ing and if you ask any doc­tor about burnout, they’ll ask you which burnout story do you want to hear,” says Water­ford-based Rowe.

“You are deal­ing with in­creas­ingly com­plex cases — you could have peo­ple on up to 20 dif­fer­ent tablets daily.”

Then, there’s the long hours, and the rise in lit­i­ga­tion, which is an­other stres­sor for over­worked doc­tors.

“Sys­tems are far from perfect and mis­takes hap­pen, but there’s now a cul­ture of ‘hang the doc­tor out to dry’, rather than look­ing at the sys­tem around some­thing. This puts a lot of pres­sure on doc­tors — the fear of be­ing sued.

“The lack of re­sources and lack of ac­cess to cen­tral ser­vices is a ma­jor is­sue.

“It’s not ac­cept­able that peo­ple in Ire­land have to wait so long to get ba­sic tests. This frus­tra­tion for pa­tients af­fects the doc­tors,” says Dr Rowe. “A lot of GPs are go­ing to Aus­tralia and Canada — they’re mov­ing there be­cause of money, but the rea­son a lot of them are stay­ing is be­cause the sys­tems are much bet­ter. In Aus­tralia, if some­one has a prob­lem, they can have their scans done on the same day and the GP will have the re­sults back that evening and get a spe­cial­ist to see the pa­tient the day af­ter,” he says. Doc­tors in Ire­land work ex­tremely hard and in very dif­fi­cult con­di­tions, adds Dr Rowe. “A doc­tor can find him­self or her­self work­ing all the time and ne­glect­ing health and key re­la­tion­ships,” he warns. “At a fun­da­men­tal level health needs to be val­ued as a re­source rather than as a cost and the peo­ple who pro­vide health­care need to be val­ued as re­sources and not just seen as a cost.”

Also Hu­man: The In­ner Lives of Doc­tors, by Caro­line Elton, a Heine­mann hard­back, €23.79 * Names have been changed

Newspapers in English

Newspapers from Ireland

© PressReader. All rights reserved.