The last 12 months have tested Australia’s healthcare system like no other time in living memory.
Bushfires swept through vast swathes of our country, claiming lives and destroying homes and businesses. Smoke blanketed our towns and cities and left people with respiratory conditions gasping for air.
Then came a global pandemic. Although Australia has managed to avoid the worst of what some other countries have experienced, COVID-19 has killed hundreds of people, devastated livelihoods and tested our resolve as individuals and as a nation.
The General Practice: Health of the Nation 2020 report reveals what many of us already knew: GPs are essential when crisis strikes.
Our GPs have done an outstanding job helping their communities heal. Over many months, GPs have stepped up to help in the regions hit hardest by the bushfires, helping people experiencing injuries and trauma and coordinating local health responses. And they will carry on supporting their communities as the bushfire recovery process continues. The RACGP continues to advocate for involvement in emergency response planning to ensure the voice of general practice is heard loud and clear.
General practices across Australia adapted quickly to expand or implement telehealth services. Consultations via phone and video technology have been crucial in helping patients access care from the safety of their home during the COVID-19 pandemic. Telehealth has also likely contributed to the very low rate of infection among general practice staff.
The response to the pandemic from GPs in the Aboriginal and Torres Strait Islander health sector has been particularly successful. Decisive action to protect remote Aboriginal communities, including culturally appropriate public health messages from Aboriginal-led health services, has undoubtedly saved lives.
Even with the recent decision to prioritise visas for international medical graduates and overseas-trained doctors, the temporary closure of Australia’s borders during the pandemic, combined with movement restrictions, has affected rural general practice. Almost half the rural GP workforce consists of doctors from overseas. However, the RACGP is making solid progress towards addressing shortages, including a 40% increase in junior doctors choosing the rural generalist pathway when applying for Australian General Practice Training.
Looking ahead, many challenges remain.
GPs will almost certainly see an increase in patients presenting with mental health issues following the pandemic. As the first port of call for those with mental health concerns, GPs stand at the ready.
We’re also deeply concerned about the possible downstream effects of people delaying or avoiding seeking care during the pandemic. This report shows a significant decrease in the number of GPs reporting musculoskeletal, circulatory, and endocrine and metabolic issues as the most common presentations.
On top of that is the emerging evidence of the long‑term impacts of the virus itself on patient wellbeing. GPs can expect to see more physical, cognitive and psychological issues from COVID-19-positive patients in the months and years to come.
Clearly, many patients will need ongoing support from their GPs. However, in the midst of these challenges, I also see opportunity – opportunity to change how primary care is delivered to improve health outcomes in a more cost-effective way. This year has highlighted how essential GPs are when health crises strike – but we must not revert to the status quo when the grip of the pandemic eases.
The solutions are right in front of us.
The RACGP’s Vision for general practice and a sustainable healthcare system outlines a model of care that addresses many of the nation’s healthcare challenges. Those challenges are only set to grow in the wake of the pandemic, so we don’t have a moment to lose.
Continuity of care is vital to improving patient health outcomes and reducing hospitalisations. Medical experts and policymakers have long called for a voluntary patient-enrolment model to help coordinate access to multidisciplinary care. Such a model would support GPs and practice teams to better manage chronic disease and mental health issues.
The extension of Medicare subsidies for telehealth services to 31 March 2021 is welcome, but a longer‑term plan is needed. There’s no turning back – patients and GPs have seen how valuable these services are. If Medicare subsidies were available for longer mental health consultations, patients would be better supported to talk to their GP about what they’re experiencing.
We must learn from what we’ve experienced in 2020 and work constructively with all levels of government to achieve lasting primary care reforms that will benefit generations to come.
GPs are among the heroes of the bushfires and pandemic. They’ve demonstrated a resilience, adaptability, positivity and empathy that’s nothing short of inspiring.
Associate Professor Ayman Shenouda
Acting President, RACGP
November 2020