Sometimes a patient has to wait 45 minutes before the doctor’s assistant picks up the phone. And then that person can only see the doctor two weeks later. “This can make the patient angry, he wants an appointment now,” says Annemiek Beukman, director of the Healthy op Zuid Foundation. (seven GP practices). “It is manageable to talk to an aggressive patient once in a while. But every day is not fun.”
The shortage of general practitioners and their assistants can be felt every day in Zuid
The shortage of general practitioners and doctor’s assistants can be felt every day in South Rotterdam. In the summer it is always fitting and measuring in healthcare, but this summer it is dramatic in many general practices. There is a chronic shortage of regular GPs, and many observers (freelance GPs) are currently hired by the GGD for supervision during the Covid vaccinations in the injection halls. Huisartshulp, which is recruiting staff, warns on Facebook that it will be so difficult to find people this year that many GPs and assistants will not be able to go on holiday this year.
At the same time, says GP Henk Hoogervorst, many patients who did not dare to come to the practice for a year for fear of becoming infected, now want to make an appointment. Hoogervorst is chairman of the general practitioners’ circle in the Rotterdam region, to which six hundred general practitioners are affiliated.
GP practices across the country are noticing this. Many patients have kept quiet for a year and a half, says Guus Jaspar of the National Association of General Practitioners. “Now, with the euphoric mood of: we are done with the lockdown, there is a huge wave of questions for general practitioners.”
Like with Arjan Roest, from a practice in Middelburg. “People have been suffering from a spot on the skin, or a pain in the back for a while. Now go to the doctor.”
Roest’s practice also suffers from what he calls “faltering” vaccination policies. For example, if it is announced on television that after a shot of AstraZeneca a shot of Pfizer is also allowed, the next morning the telephone at his practice is red hot. What does the doctor think is sensible? And can they get that shot from him too? Not that he blames the patients, says Roest, he understands their questions.
Nationally, it is also a factor that GPs now want to go on holiday themselves. Preferably before September, in case there is a new wave of contamination. “They have worked hard for a year and a half,” says Jaspar of the National Association of General Practitioners. “Now that the weather is possible, they also want to get away for a while.”
It’s temporary issues like this that are making GP practices close to succumbing this summer. But the underlying problems are structural. In many regions there is a growing shortage of GPs. In Zeeland, for example, where it is also expected that almost half of the general practitioners will retire within ten years. The replacement for the Zeeland GP Roest for the summer holidays comes all the way from Groningen. “That shows how difficult it is.”
The driving force behind the problems is the changing labor market of GPs. The classical general practitioner was usually a man who worked day and night and knew his patients well. Since 2016, women have been in the majority among general practitioners. They more often opt for part-time work than their male colleagues. In addition, they are less likely to move to remote areas because they take their partner’s work into account more often.
Then there is the unpopularity of practical ownership. Running a practice has become increasingly complicated in recent years, due to all kinds of requirements from regulators and insurers. Young GPs often don’t feel like it. Observing is lucrative and is less hassle than a permanent job. The worries of getting rosters around and being an employer – who has a regular, practicing GP – are absent for observers.
In addition, says director Annemiek Beukman in South Rotterdam, “young general practitioners do not always opt for a permanent job in a deprived area. They work with us for a while and think: do I want this? Some have been touched and want to stay, but others are leaving. The demand is so great everywhere.” And so deprived neighborhoods and peripheral regions feel the shortage the hardest.
Not an easy work area
Rotterdam South is not an easy work area, she says. There is a lot of unemployment, depression, obesity, debt, alcohol and cigarette addiction and many single-parent families. Many patients do not speak the language. “Some people visit the doctor every week.” Beukman notices that you have to be enthusiastic to work here for a long time. “Fortunately, those doctors exist. But there are too few and less and less.” The trainee GPs, the trainee assistants, the observers who work temporarily in South Rotterdam – they come and go again.
The GP has to receive more and more care that nursing homes previously provided leverde
And then there are the general trends that put an extra burden on all general practices: they have to receive more and more care that was previously provided by nursing homes and psychiatric institutions. The elderly live at home for much longer and only go to a nursing home if they need care 24 hours a day, seven days a week. Psychiatric patients are much more likely to live at home, in a residential area, and not in a mental health institution as in the past. Chronic patients – with diabetes, COPD or otherwise – no longer go to the hospital for check-ups but to the GP.
Henk Hoogervorst and his wife have a classical practice at home in Hellevoetsluis. They have both always worked full time. “It is still a wonderful profession, but we are sixty and, like many general practitioners, we will retire in a few years. Finding a successor for a practice like this, where you are available 24/7, is difficult.”
GP practices are almost succumbing to the doctor shortage
Source link GP practices are almost succumbing to the doctor shortage