Today, May 19th, is World Family Doctor Day. This is the day when we general practitioners / family physicians / primary care doctors get to sit back, crack out the party poppers and pat ourselves on the back for the good work we do for our patients and communities.
Here in Australia, we instinctively know how important we are in the health system. We know that we do the vast majority of the medical care in this country, with only a small proportion of our patients ever stepping foot in our secondary and tertiary hospitals. We also know that without strong primary care, the overall health system would crumble. In our low tech setting we use our clinical judgement to absorb a lot of the risk of uncertainty, keeping acutely unwell patients out of emergency departments. Our focus on preventive health care keeps the population healthier for longer, reducing the burden of chronic disease. Our gate keeping role means that we maintain a broad and comprehensive skill set, and that specialists are only involved for problems that are beyond our realm of expertise.
And yet we know that we have a lot of challenges ahead. Our patients are getting older, fatter and more complex. The rapid turnover of information makes it near impossible to keep our clinical knowledge completely up-to-date. Our status and remuneration still lags behind specialists even though being a good GP is one of the hardest jobs in medicine. The vocal promoters of dangerous pseudoscience threaten the foundation of trust of the doctor-patient relationship. Plus, there simply aren’t enough of us, particularly in rural, remote, outer metropolitan and underprivileged areas.
In particular, the business of General Practice is becoming more and more burdensome. It saddens me that so many of my respected GP colleagues are devoting so much time and energy worrying about how they can balance quality and equitable care with a viable business. It also seems unfair that GPs have to chose between charging a fee that reflects what they’re worth, and taking a significant pay cut so that their patients can access the care they need.
These dilemmas are particularly topical given the recent budget announcements and proposed co-payment. We all know patients who literally will not be able to afford to come to the doctor, let alone pay for essential blood tests and imaging. There is no doubt in my mind that the most vulnerable patients will rationalise their visits to the doctor in favour of other essentials, and eventually turn up sicker on our hospital doorsteps. And there’s been a collective *facepalm* around the country with the news that the $7 fee will apply to vaccinations. It was already tough enough message to sell even when it was free!
Yet – here in Australia, we are better off than most. There are many countries struggling to get primary care recognised by their governments, some who’s primary care sector is being gradually eroded and some where there is little or no primary care at all. I am grateful for the work of the the world organisation of family doctors (WONCA) which tirelessly works to improve the health of people worldwide by fostering high standards of primary care. Its efforts make the world a better place.
Despite the difficulties and the uncertainty of the future, I am still immensely proud to be a GP. I’m so proud of my colleagues and the fantastic care that our communities get because of our world-class primary care skills. I still think that GP is the best job in the world and I feel enormously privileged to do this important work.
To my patients who allow me to share their fears, joys, suffering and triumphs – thank you!
To my own GP, who is an absolute superstar – thank you!
To the GPs all over Australia who look after my friends and family so well – thank you!
To my colleagues both locally and globally who are doing their best for their communities – thank you!
To anyone involved in teaching and training the next generation of GPs – thank you!
To those up-and-coming future family doctors – welcome to the profession! You have chosen a most rewarding and worthy path.
Happy Family Doctor Day!