Thu 8th Feb 2018
GPs need to be recognised as the specialists they are
Source: Age Sydney Morning HeraldEvery day in Australia, thousands of medical decisions are made by people with no health training at all – and general practitioners like me are furious and frustrated that our training is often seen as not good enough by the paper-pushers.
I reached boiling point last week after spending an hour on the phone trying to get a taxi subsidy for one of my patients. There are plenty of boxes to tick to get a taxi subsidy, but specifically you need a specialist letter confirming you cannot walk 20 metres without assistance. So what about a woman in her 70s with multiple problems who can usually walk 100 metres slowly, who has just had a major operation?
This case was a medical emergency. My patient was expecting to be discharged from hospital within 48 hours. She was worried about her ability to shower alone, let alone walk 20 metres or drive herself to her dialysis treatment, which she needs three times a week to stay alive.
Her story had been clearly outlined to the paper-pushers. But they still asked me for a specialist letter. So which specialist? The kidney specialist who can talk about the renal failure? The joint specialist who will only write that she can walk 100 metres usually? Or the surgeon who didn’t have time to write the letter himself? I went with the surgeon – and wrote it for him, emailing it to his secretary for his scribble at the bottom.
Emma Skowronski says as a GP she plays a key role in co-ordinating care for her patients with complex problems.
The Royal College of General Practitioners has been running a campaign highlighting the specialist role GPs play in our health system. Many studies show the health dollar is most economically spent in general practice, because the GP plays a key role in co-ordinating care for patients just like mine.
People with complex problems have many specialists and someone needs to act as the medical linchpin, holding the patient’s various medical concerns together with the information about their home situation, their family background and the personal details about their lives they may not have shared with anyone else. More often than not, it is your GP who will go in to bat for you when the system fails to recognise how all those little boxes actually play out in your life.
We need people with medical backgrounds to sit on advisory boards and shine a light on the reality of health problems – how they play out in the lives of the people at the other end of the paper trail.
And we need GPs to be recognised as the specialists we are. We are the ones with a comprehensive understanding of the health and situation of our patients. Our testimony should be enough to get them the services they need.
No more boxes. It is time for compassion.