Growth in ‘telehealth’ work concerns some GPs

A Health New Zealand Te Whatu Ora (HNZ) boss says up to half of all GP work could be done by telehealth — including by overseasbased doctors.

The agency’s director of living well, Martin Hefford, was speaking at the ‘‘Building the Future of Health’’ hui, a regular webinar to update health professionals — and anyone else interested — on HNZ’s work. Mr Hefford said the ‘‘medical cavalry’’ was not coming to rescue the country from its shortage of general practitioners, which was predicted to grow to 1000 by 2033.

About 40% to 50% of GP work could be done by telehealth consultations, he said.

‘‘We are not going to be able to train enough doctors to cover the GP shortage that we forecast and we need to look at other ways of managing access and managing health problems and demand.’’

Telehealth is when patients have appointments with their GP via video or phone calls. Because the location of GPs did not always align with where there was the greatest need, telehealth could give more people access to care, he said. And help could come from outside of the country too.

‘‘It’s a great opportunity to balance demand in rural areas, demand in areas with highneed populations, with people who might be operating from anywhere in New Zealand or anywhere actually in the world, providing they are New Zealandtrained or New Zealandaccredited.’’

A GP group said it was ‘‘dismayed’’ by the comments.

The General Practitioners Owners Association chairman Angus Chambers said it showed HNZ did not understand the work of GPs.

Telehealth was a great complement to general practice for matters that did not need facetoface intervention, but there was other care that could only be achieved by being in the same room with someone. That included ‘‘opportunistic care’’. That was where doctors might notice another problem or take the chance to talk to their patients about a matter they had not come to the doctor about. He was also annoyed by Mr Hefford’s suggestion that nondoctor roles play a greater part in clinical care — such as nurses, healthcare assistants, physios and health coaches. ‘‘This is yet another example of Te Whatu Ora misunderstanding and undervaluing GPs’ work. Mr Hefford also claimed that 20% of general practice work could be undertaken by physiotherapists. This is just ludicrous and assumes that the diagnosis has somehow been achieved without a GP,’’ Mr Chambers said.

However, Health New Zealand said greater use of telehealth services would ‘‘free up’’ GPs to focus on complex patients. The national clinical director of primary care, Dr Sarah Clarke, said the agency was working to boost the GP workforce with extra funding and training places, but critical shortages remained.

‘‘Despite our best efforts, we still don’t have enough GPs, and we will have to work together as a system to redirect some of the tasks GPs do so they can focus their time on the complex care that is done best by our valued GP workforce,’’ she said in a written response to RNZ.

‘‘We know that continuity of care in general practice is important, and that being with the same provider for at least 15 years significantly reduces the risk of death, the need for acute care afterhours, and hospital admissions. In a model where you know your patient, continuity can be maintained while a lot of care is provided via telehealth, as is already happening right across Aotearoa.’’

❛ This is yet another example of Te Whatu Ora misunderstanding and undervaluing GPs’ work General Practitioners Owners Association chairman Angus Chambers