While GPs may be finding themselves spread thin, it’s not necessarily the challenges of the pandemic that are to blame.
GPs need to be given greater support in caring for patients with long covid, the RACGP has told a government inquiry into the chronic condition.
However, RACGP president Adjunct Professor Karen Price said the challenges that GPs with these patients face partly stem from shortcomings in the Medicare system that affect the wider healthcare profession.
In its submission to the House inquiry into long COVID and repeated COVID infections, the college recommends:
- GPs are acknowledged as being best placed to provide coordinated care for patients with long covid
- current inadequacies in the Medicare Benefits Schedule to support patients with long covid must be addressed
- an agreed definition of long covid be established as an essential component of a plan to support appropriate assessment, diagnosis, and management
- that inequities be addressed to ensure all patients, irrespective of location or social factors, have access to best-practice medical care and support
- long covid data is captured in primary care to understand the breadth and impact of this chronic condition in Australia and standards are implemented to create consistent clinical coding to support consistent data capture in electronic medical records
- funding is directed to general practice research into long covid, with GPs leading this research and the interpretation of primary care data
“Patients are reporting problems navigating the health system to get proper long covid assessment, diagnosis, and appropriate treatment and that must change,” Professor Price said. “There are not enough specialist long covid clinics, especially in rural and remote areas, and those clinics that are up and running can’t meet demand. There are also long wait times for review and input by other medical specialists and allied health professionals.”
But while patients faced limited access to medical and allied heath appointments, as well as potentially substantial out-of-pocket fees, GPs were facing challenges of their own.
“The MBS is not fit for purpose for managing long covid patients,” said Professor Price. “GPs are reporting confusion on the use of different Medicare items, including GP Chronic Disease Management items in the context of long covid as well as Team Care Arrangements.
“Yet again the fiendishly complex Medicare system is making the job of GPs that much harder than it needs to be. The unique circumstance of this complex condition requires further clarity on the use of the relevant Medicare item numbers so that GPs have certainty in what they are doing.”
According to Professor Price, long covid patients with other chronic conditions provide a clear example of the shortcomings of a rebate structure that discourages GPs from spending longer amounts of time with patients who have multiple, complex conditions.
The government’s long covid inquiry will hear about the personal experiences of patients and healthcare professionals in dealing with a condition about which much remains unknown.
However, it will also look at the health, social, educational and economic impacts on individuals who develop long COVID or who have repeated COVID infections. The effects on their families and the broader community, including for groups that face a greater risk of serious illness due to factors such as existing health conditions, disability or background, will also be considered.
The way long covid impacts the overall health system will also go under the spotlight. This includes in relation to deferred treatment, reduced health screening, postponed elective surgery, and increased risk of various conditions including cardiovascular, neurological and immunological conditions in the general population.
Submissions to the inquiry close tomorrow, Friday 18 November.
