Absolutely spot on John.   These 2am 'covering their arse' type calls must
be eliminated if any gp in his right mind wants to continue.     We had one
last night who "rolled out of bed" at 3am triggering a whole
ambulance/hospital/notify gp incident simply because of a 'protocol' being
implemented by a person with no medical training or skills whatever.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of John Mackenzie
Sent: Saturday, 24 February 2007 10:50 AM
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] Re: Rural GP shortage - solution


>Do you envision one GPassist type dr per rural hospital or would one, or a
>couple possibly cover multiple hospitals? 
>Good luck and then can we tackle the problem of not having rural GPs at
all? 
>

Jan, no offense intended, but these 2 questions show
no understanding of rural general practice or the present
crisis where there are far too few rural GPs (the vast
majority now being overseas trained doctors who have
been poached from their countries of training). 

A lot of the reason is that the doctors and their families
prefer to live in cities to be near their friends, family,
schools and facilities- this can never be changed. 
But there is also the problem that the after hours burden
of work is absolutely crushing - so those GPs who much
prefer the diversity of rural practice (and there are many
of these, such as me) just cave in through sleep deprevation
and exhaustion.
A lot of this after hours burden is petty little stuff - the
nursing home rings at 2am to say MrsM has fallen out
of bed, she seems OK but they needed to tell the
doctor in case something happens; or another patient
has a headache at 2am, can he have 2 Panadol, etc, etc. 

My proposal is for there to be a GPassist after hours
call centre which can take first calls, but there still needs
to be a local GP acting as 2nd on-call for the 10% of
problems that can't be dealt with by the GPassist 1st on-call.

Probably 2-3 GPassist after hours doctors could cover
all of rural Australia (1 GPassist type doctor per rural
hospital is absurd). 

The reduction in sleep disturbance and after hours calls
would make rural general practice far more attractive to
GPs.  So these rural GPs would not burn out and return to
the sanctuary of the cities.  Instead the rural communities
would attract and keep their GPs, who wouldn't be
dangerously sleep deprived most of the time.

This proposal doesn't replace or reduce rural GP numbers,
but it very much encourages GPs to go and stay in rural
practice.

Of course, it's far more convenient for patients and hospital
nurses to just ring the rural GP that they know 24/7 and have
them pandering to their every whim.  This is what kills off the
rural GPs so you then haven't got any => crisis.  My proposal
is a solution to this crisis. 

John Mac
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