30 Jun 2022

'Tsunami' of respiratory illness overwhelming clinics - urgent care doctor

From Checkpoint, 5:43 pm on 30 June 2022

The ongoing spread of Omicron, influenza and other winter illnesses is being described by one urgent care doctor as a "tsunami".

Health Minster Andrew Little said the health system as a whole is managing, but Waikato emergency clinic doctor Lesley Topping firmly disagrees.

She was called into work on what should have been her two days off this week.

"A waiting room full of crying children, coughing people, distressed people, people with bandages on their hands, just looking blankly and waiting."

Dr Topping told Checkpoint some would wait for up to five hours.

"Mothers with children who'd been up all night, who waited from 10am till 3pm to be seen."

She had a 40-year career as a general practitioner, and now works as a doctor in urgent care – a service with more challenges, she said.

"In general practice you have appointments and people come in. But the trouble is that the people in urgent care people just arrive when they arrive around the clock. And many of them are telling us that they can't get an appointment with their GP for three weeks or so.

"The other problem is the elderly come in with complex problems. They can't get to their GP and we have no idea of the background, what medication they're on, and what complex problems they have, so we're working from scratch."

Now Dr Topping works an eight-hour shift, but she said a GP will often spend another two to four hours doing paperwork after seeing patients.

In urgent care, a doctor works their way through a huge list of patients, she said.

"You do your best for them and you carry on to the next one. And you just do that as fast as you can without making mistakes, if possible. And it's tense. You're feeling for your a patients. You're feeling for how long they've waited, but you still are trying to do your best to do a decent job.

"It's exhausting."

One solution to ease the crisis would be an education campaign to help people know when to come to a clinic and when they don't need to, Dr Topping said.

"To not come in at the first cough or the first vomit, or not even the second one, but to come in when they short of breath, to come in when the child is lethargic and listless and not eating and drinking at all.

"To come in when they're really worried. But if they've got a small cut or they've got a bit of a cold, they might be miserable, yes. But unless they're really sick, please stay at home."

Despite stories from around the country about overwhelmed clinics and hospitals, Health Minister Andrew Little said he is satisfied the health system is managing overall.

"Absolutely not," Dr Topping said.

"And I worry terribly because the average age of GPs is well over 50. Half of them are planning to retire and if they burn out with this sort of thing, they'll retire earlier and the whole problem will be exacerbated even worse."

She said she does not really have faith her concerns are being heard by those in power.

"GPs have always been the poor cousin. Hospitals and their waiting lists have always carried more weight politically.

"And there's been a sinking lid on GP income, so people don't want to do it. They've got student loans to pay off, they need to earn an income.

"So not many people are coming into general practice. The same goes for nursing… with nurses departing to the DHBs because they've had a pay rise and we can't afford to give them one, or they're departing to Australia where they can earn double.

"And the Health Minister just says we're coping."

Dr Topping's clinic has approximately half the staff it needs, she said. It is considerably less than a couple of years ago.

"And we've got a bigger load at the moment with this tsunami of respiratory illnesses. And we've also had a huge amount of diarrhoea and vomiting lately, plus the ordinary stuff."

After 40 years as a GP, Dr Topping is near retirement, and she said she is working as hard as she ever has.

"Mostly out of concern for the system and the patients. But there's an awful lot of doctors in my age group. And I don't know who's going to look after me when I do retire."

If there was better pay and recognition for GPs, Dr Topping said she would recommend the job.

"Absolutely. I have loved being a GP. I have loved seeing people grow up. I have loved delivering babies and then seeing them grow up, looking after families of several generations and looking after the babies of the of the babies are delivered. It's the most satisfying thing."