General practice has become less attractive as a speciality with the shrinking level of capitation funding and money paid to practices for each enrolled patient. Photo: 123rf
The government's plans for a new 24-7 Telehealth service will end up delivering "hit and run" medicine and substandard care for patients, warns a leading GP.
Health NZ has confirmed the service - due to go live from as early as next month - will involve multiple providers and a shared digital health record.
The Digital Health Association chair said the service would making it easier for patients to access a doctor and help to avoid "clogging up the hospital system".
However, the chair of general practitioners Aotearoa Dr Buzz Burrell told Nine to Noon it would inevitably lead to "further fragmentation of good old general practice".
"And if we fragment and dismantle general practice, we're going backwards, not forwards."
Dr Burrell said to his knowledge, no GP organisations had been consulted over the design of the new Telehealth platform, which was concerning.
"Unfortunately what it's going to look like is a patient is going to phone a doctor, a nurse, a paramedic, who is not their doctor or nurse or health practitioner.
"As a result that continuity will be fractured, it will be hit and run medicine, and it's not fixing the problem."
The underlying problem was the acute shortage of GPs in New Zealand, which needed another 500 to 1000 family doctors to be on par with Australia, he said.
"The solution is not funding private companies to make money out of patients phoning them up instead of their doctors - it's getting more doctors on the front-line."
Research had shown that patients who had the same GP for five years, lived four years longer on average, and had 30 percent fewer referrals to secondary services, Burrell said.
"I recall very well in deed having one Telehealth consult during COVID with a patient I knew well, and I said 'Gosh, I have to see you next week', and I did.
"What they had called me about was one problem, but what I saw was a pale person who had lost weight. And to cut a long story short he had his bowel cancer resected three months later.
"That would have been completely missed had he been seen by one doctor who he'd never seen before and would never see again. That's hit and run medicine."
General practice had become less attractive as a speciality with the shrinking level of capitation funding, the money paid to practices for each enrolled patient, with up to 40 percent of practices struggling to stay financially viable.
Digital healthcare providers said however the Telehealth service should bring more equitable access to GPs across the country.
The Digital Health Association chair Tony Wai told the Nine to Noon many GPs offered online appointments but not 24-hour coverage.
"It will hopefully pick up a number of the unenrolled who don't have a current GP and we know a number of those individuals have been winding up in ED across the country, and that's clogging up the hospital system.
"Trying to get immediate access to a doctor is going to be crucial upfront, there will be a number of people using it who will be in major distress in that point of time and getting them immediate access is much easier."
Wai said it would take less time to get access to a doctor and reduce the overall wait times.
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