More than three-quarters of Ireland’s approximately 2,500 general practitioners have stopped accepting new patients, according to the Irish Association of General Practitioners.
General practitioners across the country say they are overwhelmed with workloads, with many practices struggling to attract young, qualified applicants, especially in rural and poor areas.
In July 2022, Dr Martin Daly and his wife almost closed their GP practice in the Galway town of Ballygar.
They haven’t been able to take a family vacation for the past three years because they haven’t been able to get temporary protection.
The global shortage of doctors is hitting Irish GPs and patients hard.
Although Ireland’s population has increased by approximately 50% over the past 30 years, the number of general practitioners trained or employed in Ireland has not increased commensurately.
Attitudes have also changed. When Dr. Daly qualified as a general practitioner, it was common for rural doctors to work 60 hours a week or 70 hours a week.
“A young general practitioner wouldn’t do that, and rightfully so,” Dr Daly said.
“They have the right to take time off for their families, for their education, for sick and maternity leave, and to take time off just like anyone else in society.”
“We were very fortunate last year to recruit a young partner, which saved the practice,” Dr. Daly said.
“This leads to delayed diagnosis, overcrowding in A&E and, in turn, GP burnout.”
Andrew Murphy is Professor of General Practice at the University of Galway and a practicing General Practitioner with over 30 years’ experience.
He said another reason for the increased demand for general practitioners is that patient demands are changing as the population ages and healthcare becomes more complex.
“When I qualified, very few patients were taking more than 10 medicines. Today, 5% of all patients in Ireland aged over 65 are taking 15 or more medicines. Masu.”
A survey by the Irish College of General Practitioners last year found that three-quarters of general practitioners had closed their lists, meaning they were refusing to accept new patients. Dr. Murphy’s practice was among them.
“We had never done anything like that before,” Dr. Murphy said, but the practice could not keep up with the demand for their services.
“All of this means there is an unmet need for patients,” he said.
“This leads to delays in diagnosis, overcrowding in A&E and, in turn, GP burnout.”
Even patients who make it through GP waiting lists may be delayed in receiving the care they need.
GPs can refer patients to see consultants, but the waiting list can be years long.
Meanwhile, patients whose health problems worsen return to their primary care physician.
Drogheda-based GP Amy Morgan said she had observed this in her own practice.
“The situation is getting worse,” she said.
“You’re probably seeing the same patient multiple times in quick succession because they’re still waiting to be seen. You may be making the most of what you have to offer.”
Dr Morgan added that it would also increase the burden on GPs in terms of administrative tasks.
Tadgh Crowley is Chair of the GP Committee of the Irish Medical Authority. The problem of GP burnout, partly due to consultant waiting lists, is an issue he has heard from members and one he has seen himself.
“Some of the common practices are to take care of patients from cradle to grave, refer them to the hospital if there are issues that require a consultant’s opinion, seek medical attention at the right time, and then the patient returns. “Our own,” he said.
He added: “If you have someone who goes to an orthopedic clinic and is waiting for a hip replacement, they’re suffering from chronic pain, they’re having recurrences, and they’re on painkillers. .
“I see their lives becoming more precarious right before my eyes.
“They’re in pain. They’re awake a lot. It affects their mood. And we know what they need, but the system isn’t allowing it.” There just isn’t one.
“It’s frustrating and a little stressful,” he said.
Dr Crowley said that to increase the number of GPs, we need to recruit more doctors, retain existing doctors and encourage those who have left the profession or country to return.
“There’s really no support to help new GPs set up a practice from scratch.”
But he said there was also a need to look at where there were not enough GPs in Ireland and set up concrete schemes to encourage GPs to respond to those needs.
Most GP practices are set up as businesses rather than employees, so no one is monitoring where more doctors are needed in the community.
One general practitioner who has relocated to an underserved area is Dr Mark Murphy. Six years ago, he set up a general practitioner practice in south Dublin with two others.
He found the process of setting up a clinic very difficult, with little roadmap or assistance available to practitioners in establishing their business.
“There’s really no support for new GPs to help them set up a practice from scratch,” he says.
“More coordinated planning is needed in urban and impoverished areas,” Dr. Murphy said, adding that “more than just luck is involved” in whether practitioners can open clinics in these areas. Ta.
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An analysis of where communities most need GPs would be welcomed by IMO’s Dr Crowley.
“We need a cross-sectoral policy,” he said, adding that a country-wide map needs to be created to identify areas where GPs are needed.
“Then we will look at how we can set up GP practices and incentivize them to come to our area and ensure we stay.”
More than 700 GPs are set to retire over the next five years, but ESRI estimates that around twice that many GPs will need to be recruited by 2028.
Meanwhile, Ireland’s population is one of the fastest growing in Europe.
Back in Ballygar, Galway, Dr Daly stressed that the demand for GPs will also impact on reception and nursing staff within clinics.
“Ultimately, patients who 10 to 15 years ago were able to come to our surgery on the same day without an appointment and be seen, but now they don’t understand why they have to wait for a regular appointment. It’s a cultural change and it’s difficult for people. ”