A bombshell report from the RACGP this week highlighted the financial pressures GPs are under, but what about rude and demanding patients and the perception of GPs as second-class citizens in a dysfunctional health system?

It’s not just plummeting financial viability and mountains of paperwork that have GPs concerned about the future of general practice.

A survey by Healthed on 27 September teased out some of the other factors that are significantly degrading working conditions of GPs. And it wasn’t COVID or the new CPD at the top of the list – it was demanding and difficult patients and lack of respect for general practice by government and other specialists.

The 27 September survey was inspired by a previous Healthed survey, in which GPs provided scathing comments about current working conditions.

This biting commentary contained some raw truths about what working life is like for many GPs. Here are some with which Healthed’s medical editors really empathised:

“Patients are increasingly more demanding, anxious and entitled, expecting to be seen at their convenience and often with long lists of problems and unrealistic expectations about the time frame involved to deal with these issues appropriately.”

“Despite a wonderful community, there are more abusive patients, which affects GPs, staff and the waiting room patients. (I’m aware of a patient invading a colleague’s room today without permission, and abusing reception staff.) GPs are meat in the sandwich between under-resourced hospitals, and suffer unfair and poor pay, no lunchtimes and no time to pee. I’ve stopped bulk billing even pensioners this week as its emotional abuse for nurses and doctors to depend on bulk billing under these conditions.”

“We are treated as second class doctors compared to our specialist colleagues, yet we end up providing far more all-round services for our patients then they do.”

“We are expected to complete numerous documents for multiple agencies. Many specialists fail to support us, yet we seem to be forever writing referrals and renewing referrals for them. And Hospital Discharge Summaries are near ‘non- existent’. If they do arrive, they are so late to be useless and most often written by the most junior member of the treating team or one who was not even involved with the patient’s care.”

“Increasing and unrealistic demands from patients, especially phone requests for absolutely everything and ‘now’. Minimal support from government. Who will provide primary practice care in the future? Nurses and pharmacists are not able to provide GP care but government policies seem to support those fields over ours.”

“Something has to be done about aggressive behaviour and drug seeking patients”

“The doctor patient relationship is still assumed to exist when it suits and ignored when it does not suit.”

“We have become the scapegoats of the medical profession, treated with disrespect by the regulatory authorities”.

“If the current trend continues, eventually GPs will disappear.”

And some more colourful ones:

“We are all akin to gladiators with a very predictable end.”

“Stuffed by dumb bureaucracy.”

“It’s already ‘Mayday, Mayday…’”

“Too tired to express an opinion.”

“NO THOUGHTS, JUST WORK”

“JUST CARRY ON”

And some single words and phrases, just in case the Federal Minister for Health is looking for an executive summary:

“Disenchanting.”

“Appalling.”

“Too stressful.”

“Terrible.”

“Needs improvement.”

“Pathetic.”

“Too much paperwork. Too many phone calls.”

This is the situation, according to one GP surveyed:

“Patients have become increasingly more demanding, anxious and entitled, expecting to be seen at their convenience and often with long lists of problems and unrealistic expectations about the timeframe involved to deal with these issues appropriately. Our profession has been devalued with the rise of commercial ‘fast food’ bulk billing practices leading to the expectation of free healthcare as a right while yet demanding unlimited care and time when they have ‘a real problem’. These practices do not cater for those who have complex medical needs or substantial mental health or social issues, leaving fewer of us to manage the burden of those requiring long consultations, while our rebates and remuneration has been capped for years making it difficult to sustain good service. We are increasingly controlled as a profession, with GP training and examination processes more difficult and quixotic – little wonder we can’t attract graduates into general practice!”

The full comments from GPs are available as a PDF here.

When GPs were asked in the 27 September Healthed survey whether they would recommend general practice to a friend or colleague, the Net Promoter Score was -28, which means that GPs were more likely to dissuade others from joining the profession than they were to promote general practice as a career path.

This corresponds closely to the RACGP survey which found that fewer than half of GPs would recommend general practice as a career.

In our follow-up story to be published next Sunday, we will dive deeper into how patient expectations and demands have increased over time, and why there’s been a shift.

Despite the gloom, we did have one doctor provide a positive comment that is probably the best way to end this article: “They still love me”. Which is probably what we all wished we could experience everyday from the public that we care for!

Credits

Survey concept, design and analysis: Healthed GP advisory group
Data analysis and reporting: Yasmin Clarke
Reporting and editing: Felicity Nelson