Queuing … 1425 patients to the doctor | Panda Anku

HELEN HOLT
helen.holt@age.co.nz
Wairarapa has one of the worst patient-doctor ratios in New Zealand.
With 35 general practitioners [GP] serves a population of over 49,900 [2021 Stats NZ]said Bryan Betty, medical director of the Royal College of GPs, Wairarapa has one of the worst patient-to-GP ratios in the country. In fact, the region has had 35 general practitioners in the past two years, which has not kept pace with population growth over the period. At its current population, Wairarapa’s ratio is 1,425 residents for every full-time resident physician.
Wairarapa also had the highest percentage of elderly population in New Zealand
Betty said there is a shortage across the country, particularly in rural areas.
“Rural practices often have trouble attracting labour.
“If a rural practice has a GP there is a risk that that person will become isolated. They also have a higher duty cycle than city doctors.
“Many practices in rural areas are closing their books because the demand is so great. We’ve seen it in South Taranaki and Hawke’s Bay.”
Betty said the shortage is nationwide, exacerbated by Covid and the flu.
“GPs are busy. There are not enough general practitioners in New Zealand for our growing population. We don’t train enough and during Covid we didn’t import foreign-trained doctors. This has caused a number of issues and will take a long time to resolve.”
He said Covid lockdowns mean clinics are catching up.
“Procedures like cervical smears, mammograms, childhood vaccinations have fallen behind because we’ve focused solely on Covid.”
Nursing practitioners take over some of the GPs to fill the shortage.
A spokesman for Masterton Medical said NPs are the way of the future.
“Doctors don’t stay in one place like they used to. We cannot offer lifetime registration with a single GP.
“Nurses are very highly qualified healthcare practitioners with advanced education, clinical training and experience.”
“You can assess, diagnose and treat health problems for common and complex health conditions. This includes requesting and evaluating diagnostic tests, prescribing medication and other medical devices/treatments, and referral to a specialist. They can accept and dismiss hospitals and other health care institutions. They also integrate their holistic approach to care, which addresses the broader context of health, including individual, family and community health.”
Wairarapa has 10 NPs in seven practices. Most practices had at least one NP.
Greytown Medical [part of Five Rivers] was run by nurses but assisted by GPs when needed.
College of Nurses chief executive and Massey University professor Jenny Carryer said the two professionals were trained differently but both qualified.
“Nurses have the same ability to prescribe medication and refer patients to specialists. Legally, they can do anything a GP can do.”
The qualification process for NPs was anything but short.
“First you have to complete a three-year Bachelor of Nursing, then we recommend at least three years as a registered nurse. To qualify as a Nurse Practitioner, you must complete a Masters, which takes two years full-time, but most nurses continue to work.
“My research revealed that patients are just as satisfied with the care they receive from their nurses. People say they feel more comfortable with consultations with NPs, they have a better understanding of their condition, and they learn how to take better care of themselves, which helps them avoid hospital and ED.”
She said NPs and GPs are not in competition as there is “more than enough work for everyone”.
“The number of GPs produced annually is not enough. Also, GPs generally do not travel to rural areas. If we increase access to primary care, hospitalizations and emergency admissions will be reduced.”
Betty said that NPs who accept patients are “not ideal” but it is important that patients have access to medical care given the shortage of GPs.
“Nursing practitioners offer a very good service, but ideally they should work together with GPs.
“GPs have a clinical background while NPs have a nursing background. We still need GPs on the front lines.
“There is another training. It takes 14-15 years to qualify as a general practitioner.”
Wairarapa GPs have been under pressure since the start of winter. In July, just one practice admitted new patients due to “unprecedented demand for services during the pandemic and rising winter diseases like influenza.”
Meanwhile, a local GP said he has trouble seeing patients and completing paperwork and is working 12-hour days.
As of this week there are two practices accepting registrations – Carterton Medical and Featherston Medical.
The area also has clinics consisting primarily of nursing staff, including the First Health and Wellness Center in Lansdowne and the Pirinoa Medical Center.

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