Coronavirus: Frontline GPs warn of burnout 'crisis', plead for more support

They're on the frontlines of the pandemic, but many Kiwi GPs are burning out under strain caused by staff shortages and are battling to care for both themselves and their patients. 

Doctors like Taranaki GP Dr Rose Bruce who, from the outside, has a spring back in her step.  Behind her smile though is a story of burnout, stress and anxiety. 

Coronavirus: Frontline GPs warn of burnout 'crisis', plead for more support

"Having to step away and say 'I can't be me' was difficult. Having to admit that I can't do this. I'm depressed, I'm sad, I'm vulnerable, it was tough," she told Newshub Nation.  

"I wasn't the same happy, compassionate, empathic doctor that I'd always been. I wouldn't describe me as bitter, but I would describe myself as too busy to pause...The real thing that hurt me was I could no longer be there for my patients. Because I needed to be there for me." 

After burning out, she stepped back for a year and saw a psychologist and a psychiatrist.

"When I hit the wall, I was working between 50 and 80 hours a week and I shouldn't have been."

It's a common story among New Zealand doctors. Many Newshub Nation spoke to didn't want to share their story for fear of being stood down by the Medical Council.

The burnout is partially due to persistent workforce shortages. It's estimated about 2000 GPs are needed to fill vacancies and existing deficits and half the existing workforce is set to retire in the next decade.

"It is a frank crisis," warns Dr Bruce. 

"There are tens of thousands of Kiwis who can't get a doctor's appointment when they want one… there is an unmet need out there and that causes advanced cancer turning up too late. It causes heart disease and diabetes going untreated."

It also causes more burnt out GPs as they are forced to take on more patients with more complex health issues. In a recent survey from the Royal College of GPs, 31 percent of respondents rated themselves as high on the burnout scale - a 9 percent increase in four years.

Hawera GP Marlene Bezuidenhout knows the feeling well and has worked as a GP for 38 years. She owns Mountainview Medical and has about 2000 patients per doctor - 500 more than what's recommended. She says being a GP, despite the hardships, is in her blood. 

"I considered nursing as a career and then just ended up deciding, no, it's better to be a GP, and I've never regretted the decision."

But the long hours led to her burning out last year.

"It was desperate times and lots of no sleep, lots of crying, lots of very emotional stuff, both in private life and practice life. It was a very, very difficult time… I was exhausted. I was totally exhausted. You start fearing mistakes. You can see your staff being affected."  

Dr Bezuidenhout revealed that in her darkest moments, she even contemplated suicide.

"I must admit, sometimes it goes through your mind. Hey, this is... this would have been very nice not to be there... not to do these things, not to face all this." 

According to Dr Bryan Betty from the Royal New Zealand College of General Practitioners (RNZCGP), severe staff shortages are happening across the country.

"I would definitely say it's the worst that I have experienced, and I would say it's critical at the moment,'' he warns.

"We estimate 900 vacancies across the country - we're seeing really severe problems, Deep South, West Coast, Taranaki, Northland."

Which means many GPs aren't taking on new patients. Ten years ago 174,000 Kiwis were not enrolled with a doctor. That figure has ballooned to more than 316,000 in 2021 - a 64 percent increase. 

"In the last year we estimate a million New Zealanders have not been able to access a GP when they need medical care. Those figures are large, they are hidden and they are really alarming."

Especially alarming when compared to our neighbours in Australia. New Zealand has 74 GPs per 100,000 people while Australia has 112 per 100,000. Our shortage here is putting extra pressure on hospitals.

"ED departments get overloaded - and we hear about that all the time, those problems tend to be worse where you don't have a functioning GP sector," Dr Betty says.

Now the understaffed sector is bracing itself for when restrictions ease and COVID becomes part of a new normal.

"I've never seen my friends and colleagues so frightened, '' says Dr Bruce.

"We are ready. However, we're very nervous because we know that we've got this background rate of demand that we're not meeting and there's expected to be a surge of cases. The Ministry of Health wants us to be accessible, but there literally aren't enough bodies on the ground." 

Now Dr Bruce is begging people to get vaccinated, the most effective way for Kiwis to protect themselves against the virus and lessen strain on doctors and hospitals. 

"All of us are worried that there will be deaths, not because we haven't got good doctors or good ICU beds, but the volume of need will swamp those of us who are available to do the work," she said. 

"You're going to need to decide where to get the vaccine now or whether you flip a coin and take your one and two thousand chance of needing an ICU bed that's already got someone in it."

The sector is calling for better support from the government. GPs want Health Minister Andrew Little to increase the number of places in GP training schemes, pay them more once they're working in practices, extend consultation times, extend GP visas and open the doors of med school to anyone who can pass the exam.

Asked on Newshub Nation about what action he is taking to address the shortages, the Health Minister acknowledged more support was needed.

"In terms of numbers of GPs, with Primary Health Organisations and district health boards and other health organisations, we're constantly supporting them to recruit folks - particularly from overseas and to get them over the border to get them here," he said.

"That's a longer term plan but there's more we can do to support GPs because of the pressure that they and many other health professionals are under and we're doing that."

The extra support can't come soon enough for GPs like Dr Bezuidenhout, whose message to the Minister is simple. 

"All we are asking is just listen to us, just listen to us." 

A plea from a doctor worried that when she retires, there'll be no one to care for her patients.

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