GPs work free for more patients
Some GPs are having to work for free so they can fit in more patients, a study has found.
As part of its Your Work Counts project, the Royal New Zealand College of General Practitioners (RNZCGP) did a study to determine how much time is being spent on unrecognised and often non-remunerated work.
The study found that workforce shortages have meant specialist GPs and rural hospital doctors are having to take on more work and work longer hours.
“Until now, most discussions about the way we work have focused only on the patient-facing aspect,” RNZCGP medical director and Tauranga GP Dr Luke Bradford said.
The college wanted to highlight the amount of work that is actually required to look after a primary care patient load, he said.
“The results clearly show the demands being placed on the workforce and that there needs to be a change in thinking around GP workloads and the funding model.”
Over 400 members completed the project’s first diary study. At the end of every day for 14 days, including weekends, participants recorded the time they spent on tasks including contact time (patient consultations), non-contact clinical time, training and education, clinical governance and practice improvement and management.
Clinical contact time with patients took up the most time over the two-week period with 56.4%.
Non-contact clinical time, which consists of all the paperwork, emails and administrative tasks that follow on from patient consultations came in second at 30.8% of participants’ time.
“These results show that over an 8-hour working day (without breaks), 4.5 hours of patient consultations generates 3.5 hours of follow-up work and helps to explain why getting an appointment can be difficult,” Bradford said.
To make themselves available to see more patients, many GPs choose to move the non-contact clinical work into evenings or weekends.
“This is the work that we are not remunerated for, despite it being a core part of our role,” Bradford said.
Riccarton Clinic co-owner and GP Dr Angus Chambers said doctors at his practice were having to devote more and more of their own time to the paperwork that follows a consult.
“It’s probably about 33-50% of the time. If you consult for an hour you probably have 20 minutes of paperwork to do after.
“It adds to the burnout. It’s relentless. But when do you do it? Either in the evening or the weekend or you do it during the working day which means there’s less appointments available which means people wait longer, it’s just a compounding thing.”
RNZCGP president and Wellington GP Dr Samantha Murton said they were working longer hours to try and plug the gaps of the workforce shortages because they want to be available to patients when needed.
The extra hours of work, paired with all the follow-up work that comes with it, is not a long-term solution, Murton said.
“We do this work because it needs to be done. It is a key part of our role. Imagine the consequences if we didn’t make that referral, email a specialist, schedule a procedure or review test results.“
Having dedicated and remunerated time to do patient follow-up and administrative work during the day was “not an unreasonable expectation to have”, Bradford said.
“Neither is working more manageable hours and having a sustainable patient load.”