Why we must support and empower our General Practitioner Doctors
I've been working full-time in health, in a variety of roles since 1976. That is a long time by anyone's standards. My, how things have changed! I remember our Family GP from the 1960s, who later became one of the medical officers of ACC (Accident Compensation Commission). He was with ACC when they hired me in 1977 to set up and run its sports and recreation injury prevention and rehabilitation programmes.
While with ACC for several years and after, I have been the fly on the wall watching the transformation of the way health operates in New Zealand, and it has not been for the better. Despite the massive increases in healthcare costs, we are less healthy today than in the 1960s. New Zealand has gone from being one of the healthiest countries in the developed world to be one of the least healthy. We have gone from being one of the least medicated people to being in the top 3-4!
I have witnessed the gradual infiltration and hijacking of all levels and sectors of healthcare by Big Pharma, Big Food, and other commercially-driven interests, all of which profit from ill health - not from good health. This progressive infiltration of medicine by undesirable forces includes a massive increase in both the numbers and the power of medical specialists, academic health experts, technocrats and health bureaucrats. This is not another whacky conspiracy theory; this is the reality of the commercial world. Medicine is a great place to do business!
Consequently, there is the undermining of the authority of the GP and their ability to do their jobs. Our GPs, and medicine as a whole, have ceased to treat the "root causes" of ill-health and are now almost entirely devoted to responding to after-the-fact diseases, symptoms - not causes. Of course, this plays beautifully into the hands of the industries that develop and supply drugs, screening and imaging machines and surgical procedures and implants.
There is no money to be made from healthy people; the best money comes from people, ill from the cradle to the grave. How long a person lives is irrelevant to this warped model of health; most relevant is how much money they can extract before death from each person's pockets, and indirectly via taxpayer dollars.
The GP consultation is now limited to around 10 minutes, sometimes less, of face-to-face contact between doctor and patient. There is no such thing as a house visit by your Family Doctor anymore. All the GP has time for is to prescribe a drug from the Pharmac database of approved drugs, order a test, or refer the patient to an allied health professional or a specialist. There is no time for anything else.
I sense we are entering a crisis regarding General Practice, and I am not alone with having these concerns. Many GPs are close to retirement age or already past it, and there are not enough graduating doctors to fill the vacancies. In addition, many new GP doctors are unhappy with the high workloads, oppressive restrictions on how they may practice and the insufficient income after clinic expenses. I sense more GPs than ever are tiring and moving into other areas such as jobs with biotech firms or the Government. This is not good for you and me.
The GP of old times used to have much more flexibility with making clinical decisions. However, what a GP prescribes nowadays is excessively influenced by out of touch health professionals and administrators. Most of these managers have little or no clinical experience, or it was too long ago to now be clinically relevant. These include the health professionals who realised early in their careers that they could not stand the sight of blood, the smell of pus, or to deal all day with snotty-nosed children and needy people. So they switched to paper-pushing and policy-making with agencies like the Health Department or WHO or went to work for the biotech industry. Along with Policy Analysts and other experts in theory alone and nothing practical, they now tell highly qualified and experienced GPs how to do their jobs.
This last year may be the straw that breaks the back of GP medicine. There would be hardly a single medical clinic in New Zealand that has not had significant business disruption, affecting staffing, cash flow and profitability. Sure, Big Pharma, testing laboratories and health bureaucrats are making enormous profits from the Pandemic. However, where are those billions of dollars coming from? You are right: out of your and my pockets! Taxpayers now fund a highly profitable "Pandemic Industry". This new industry is a further hijacking of medicine, including the role of the GP. I fear we will never return to "normality". The Health Industry, based on the capitalistic profit-driven model, knows only one thing: more growth. Even if this Pandemic is eventually over, there is no way anyone will be closing the doors of this thriving business sector. I sadly predict there will be more of the same.
The GP and other community-based services now struggle to manage the upsurge of mental health crises and the consequences of delayed treatments.
Medicine, the Noble Profession, has taken a massive hit of its credibility in the eyes of so many. The loss of credibility is the consequence of those in power resorting to unethical practices, such as using misinformation, fear and terror in the name of medicine and health to get their way. As a result, the medical profession may never recover its once-proud standing in society. So let me explain what I am claiming.