Excessive paperwork, staff shortages and an aging workforce are putting extra pressure on New Zealand's medical practitioners.
Royal New Zealand College of General Practitioners president Jonathan Fox said many of Auckland's medical centers are so full they are not taking extra patients.
"A lot of my colleagues are very busy, and Auckland is growing. Some are not taking new patients and we wonder who is going to take these patients," he said.
He said there is a GP shortage up and down the country, and paperwork and other compliance issues are adding to the strain.
For every two hours of contact with a patient, Dr Fox estimates he is completing at least half an hour of paper work.
"A lot of general practitioners find it burdens them when we have a shortage of practitioners of doctors and a large number of patients so anything that takes us away from patient care tends to be stressful."
Filling out forms for ACC, WINZ and writing letters for patients were time consuming, he said.
Although administrators could complete some of the paperwork, a lot of the forms were only able to filled out by the doctor, he said.
An article in the New Zealand Medical Association Journal in 2006 said the perception of increasing paperwork was discouraging students from entering general practice and GPs are concerned with bureaucracy, burnout, time pressures and the lack of resources for patients.
"If you look at the figures a lot of us are 40 to 45 and we are all getting older. The older GPs are working quite a lot of hours, which younger GPs are not prepared to do," Dr Fox said.
He said there was now more and more women attending medical school, and some women were choosing to work fewer hours to fit family commitments around work.
In 2005, the Royal New Zealand College of General Practitioners survey showed GPs are working an average of 48 hours a week, with around 28 hours spent with patients.
Results from the survey also suggested that GPs spent about nine hours a week on patient-related paperwork and administrative work.
Dr Fox said he works around 60 hours a week. "You would probably need one or two doctors to replace the work that I do," he said.
An update of the survey report was published in March 2006, and found that "many GPs have said they are overworked, have had a 'guts full', are stressed, bored, are wasting their skilling with compliance issues, and are overburdened with bureaucracy and paperwork."
GPs Patient's Forced to A & E
North Shore Medical and Accident Clinics medical director Matt Wildbore said his centres were seeing patients that could not find a permanent GP.
"We don't want to act as people's GPs in the long term. We believe that people should have a GP and use us when GPs aren't available."
"I think that a lot of doctors are saying now that 'I am busy enough' and have closed their books."
He said both the North Shore and Rodney regions have been experiencing fast growth population growth prompting a need for more GPs in the community.
Hospital Waiting Lists Add Pressure to GPs
Heather Roy, ACT's spokesperson for health, believes the dedication and commitment of New Zealand's doctors and nurses are holding the health system together.
"When people aren't seen within six months they are taken off waiting lists and sent off to GPs. Because of the failure of our hospital system it is the GPs that are landed with taking care of sicker and sicker patients."
She said health care has become stretched since the introduction of Primary Health Organisations (PHOs), and emergency departments are picking up the shortfall.
"Particularly in rural areas, people have to travel great distances," she said.
To make matters worse, more GPs are moving offshore for better working conditions and higher salaries, she said.
"Virtually no one is interested in going into general practice," she said.
She said GPs are paid $75-$80,000 a year, whereas specialists are paid as much as $130-$140,000 a year. "That is a big salary gap."
"I just think that general practice is not as valued as a profession as it once was...I think that PHOs have a lot to answer to too."
The New Zealand Medical Association is worried about workforce shortages and stressed staff.
Chairman Dr Peter Foley said health professionals are highly sought after internationally, "so it's vital that they are made to feel valued working here".
Senior Doctors' Union president Dr Jeff Brown said the New Zealand health care system is reliant on foreign doctors for survival.
"The fundamental problem is that any medical workforce that relies on overseas doctors is not a healthy medical system. They may stop coming here," he said.
He said 41 percent of all current doctors foreign-graduates. Minister of Health David Cunliffe was unavailable for comment on Thursday and Friday.
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