GPs’ altruism has been exploited by successive governments, but together we can be heard.
General practice is in crisis, and it’s not just about money; it’s about morale.
For context: I am an immigrant, a daughter, a sister, an aunt, a friend, and a survivor. I have also been a widow, a single mother, and am currently #JustaGP.
I have navigated two degrees, brutal hospital rosters, 10 years in a rural emergency department, three years as a rural pathway general practice registrar, thousands of hours of study, accumulation of an impressive HECS debt, and three challenging exams to gain fellowship of the RACGP.
But I am not alone. Thousands of my GP colleagues, all around Australia, have stories that match (and trump) mine. The depth and breadth of experience, knowledge, wisdom, dedication, commitment, and compassion in the GP community is beyond astounding. We are a diverse, eclectic, and talented group, with wide experience of the world, which makes us perfect for the work that we do.
But here’s the rub.
GPs, by their very nature, tend to be warm, empathic human beings who often go above and beyond – late night and weekend phone calls to check on the wellbeing of patients we are worried about, lunch breaks eaten up by calls to hospital outpatient departments to advocate for patients, hours spent chasing and checking results and completing paperwork, and on it goes.
GPs do these things, often unremunerated, because we genuinely care about our patients. We genuinely care about our patients’ pain, their suffering, and our part in easing that suffering. We genuinely want to make a difference to the lives of our patients, all the while battling a fragmented healthcare system that is increasingly unfit for purpose.
This altruism, and dutifulness, unfortunately, has been ruthlessly exploited by successive governments over the past decade. While patient Medicare rebates flat-lined, and GPs increasingly absorbed the rising costs of providing quality care to patients, or started to charge gap fees out of necessity, politicians continued to spruik the notion that bulk billing is noble and good, that GPs charging gap fees are bereft of empathy and caring. The last government continued to spread misinformation about bulk billing rates, manipulating Medicare data in the process, and they continued to gaslight those on the front line. They continued to feed the public this misinformation, even as clinics closed around the country, bankrupted, leaving thousands of patients without access to primary care.
Those politicians worked hard to pit public sentiment against GPs.
The collateral damage to GP morale has been enormous.
Most GPs choose a career in general practice because they feel they can make the biggest difference to people’s lives in this area. I certainly feel that way, and I continue to believe that my impact now is far greater than my decade in emergency medicine ever was.
So, it hurts greatly, personally, morally, when we are negated, minimised, disrespected, and disregarded; when we are cast as greedy, uneducated, and unnecessary; when we are attacked by colleagues on Twitter, wanting to replace us with tick box IT applications; when some of our non-GP specialist colleagues downplay our role in the healthcare system; when politicians and state premiers publicly imply that we are derelict in our duty.
It hurts because we give this vocation our all, and we have sacrificed so much for our calling. It cuts to our core, makes us doubt whether the sacrifices we have made have been worth it.
It has the potential to make us bitter, to consider walking away from our calling in search of less emotionally taxing work. It has the potential to turn medical graduates away from a career path that has been increasingly widely denigrated. Sadly, this potential is already being realised, with GPs retiring early, reducing their hours to protect their emotional, physical, and mental health, and medical graduates voting with their feet by choosing to specialise in areas other than general practice.
But there is, perhaps, a glimmer of hope on the horizon. Social media platforms have rescued many GPs from a place of lonely despair. Private social media groups have provided safe and respectful environments within which to voice distress, despair, anger, and frustration at the status quo, and receive support, advice, and validation in return. These groups have given GPs a voice, after years of feeling unheard and ignored; they have facilitated the establishment of a GP village, within which we feel supported; they have spawned a growing chorus of connection, strength, determination, and self-belief. These groups have fostered pride in our GP profession and reinvigorated us. These groups have started to heal our profession, to address the moral injury that has beset us.
We have found our collective voice again, have started rebuilding morale, and are lifting our chins with a renewed sense of purpose. We have banded together to help forge a stronger healthcare system where quality patient care is the goal, and clinician wellbeing is acknowledged and supported. This unity and reconnection have gone some way to improving our collective morale, and to repairing the damage that has been done over the past decade.
In addition, we finally have a Health Minister in Mark Butler who appears to listen and understand the concerns that GPs hold regarding the current situation (indeed, who appears to share many of our concerns). This stance is in stark contrast to the wilful denial of the scale of the problem by successive governments over the past decade, who have ignored our increasingly desperate calls from the front line, who have ignored our warnings of disaster to come.
It’s early days yet, and there is much work to be done. The way forward will likely be bumpy and imperfect, but at least it is a way forward. I don’t have all the answers – I am not sure anyone does. But what I do have is a dawning, cautious sense of optimism that our profession is rebuilding morale, has regained its voice, is once again united, and that this unity can be used to forge change.
Dr Liesel Whyte is a Gold Coast GP and a former rural emergency physician; she tweets @drliesel.
