Research highlights main challenges faced by GPs during pandemic

General practice has underpinned Australia’s response to COVID-19 – but that role has not been without its challenges. Now new research has revealed the extent to which the pandemic has impacted GPs, with nearly 300 GPs participating in an online survey in March just as the COVID vaccine rollout began.
 
It found that 12 months into the pandemic, more than one-third of respondents were very or extremely concerned about the effects of the health crisis on their patients (40%) and delayed essential care (34%).
 
Patients ignoring clinic pre-screening measures and presenting with flu-like symptoms was another key issue for 39% of respondents.
 
Lead author Dr Tessa Copp, a Postdoctoral Research Fellow in the University of Sydney School of Public Health, told newsGP she was surprised to find very little research into general practices’ experience of the pandemic, given the ‘really significant challenges’ practices have faced.
 
‘A lot of the issues we identified have only become more pronounced now after the Delta outbreak,’ she said.
 
‘These findings just really highlight how much time GPs are having to spend constantly reacting to a very fast changing situation, and how much time they’re also spending trying to counteract misinformation that might have spread throughout the community.’

Just over one-third of surveyed GPs (37%) indicated that it was common to encounter patients who severely underestimated the risks of COVID-19, and 21% were very or extremely concerned about their patients’ willingness to accept a vaccine.
 
As a result, 25% were also very or extremely concerned about their own exposure to COVID-19, as well as the safety of their colleagues and family (36%). 
 
The findings also highlighted that many GPs have not felt that their needs are considered by state and federal governments, with 13% indicating ‘not at all’, 37% ‘a little’ and 31% ‘somewhat’.
 
Dr Copp said that while change is understandable, given the evolving nature of the pandemic, some GPs were frustrated at being informed about significant policy changes pertaining to the vaccine rollout through the media at the same time as the public.
 
‘Politicians and health officers will often make statements that have major implications for the people who deliver the vaccines without thinking through the implications,’ she said.
 
‘For example, when they decided to shorten the recommended time between AstraZeneca doses, it really jammed the switch boards for clinics, and it was difficult to change appointments already booked in.
 
‘Understandably, it’s a changing situation; some of these things can’t be avoided. But maybe some more timely [and] upfront communication.’ 
 
Study co-author Dr Marguerite Tracy, a member of RACGP Expert Committee – Quality Care (REC–QC) and senior lecturer at the Sydney School of Public Health, says GPs have been continually inundated with information, and that one clear communication pathway is needed.
 
‘It has been really challenging communicating changes and uncertainty to patients about COVID-19, restrictions, vaccines and eligibility when we have had constant evolution of the evidence and advice from government,’ she told newsGP.
 
‘There are multiple channels through which I have received information during the pandemic, [and] it can be challenging keeping up with the information from many sources.’
 
Dr Tracy added that she was not surprised by many of the study’s findings.
 
‘The issues raised by our participants were what I would have expected and what I was hearing from colleagues,’ she said.
 
‘Ensuring the safety of patients accessing general practice and the safety of staff and their families is essential.
 
‘Our survey showed that at the time of the survey, GPs were less concerned about PPE access but this survey is a year into the pandemic and most practices have found sources. Having said that almost 70% still had ongoing concerns about accessing PPE which is concerning.’
 
The majority of survey respondents were female (64%) and from New South Wales and Victoria. Most (60%) had undertaken their medical training in Australia and worked at an inner city (44%) or outer urban (26%) practice, and were primarily bulk-billing (53%).
 
The most common issues and requests GPs reported their patients presenting with were more information about COVID-19 vaccines (51%), what symptoms indicate a need for testing (50%), asking for advice about testing (45%), and anxiety and mental health issues associated with COVID.
 
As a result, most GPs perceived their role during the pandemic to be supporting the uptake of COVID-19 vaccines (77%), providing patients with reliable sources of information (71%) and correcting misunderstandings (71%).
 
Only a quarter of respondents indicated that they thought GPs should have a role in conducting COVID-19 tests.
 
To better support GPs as the pandemic evolves, two-thirds (67%) of participants said they wanted more education and resources about COVID-19 vaccinations, 28% wanted more information about COVID-19 treatments and 25% wanted more information about viral transmission and spread.
 
However, Dr Tracy fears that with the vaccine rollout now at a critical juncture, and booster doses having been flagged for certain cohorts, that several areas of uncertainty lay ahead for GPs.
 
‘Telehealth funding has been extended but its future is still uncertain,’ she said.
 
‘Will there be support for primary care to assist in accessing community members who have had issues accessing vaccination?
 
‘Changes to recommendations for vaccination, close contact isolation and testing of patients who have had COVID-19 are evolving and this needs clear communication to general practice.
 
‘Access to timely, accurate and reliable information in this changing environment remains [an issue].’
 
Dr Copp agrees. She says that learning to live with COVID means supporting those who are at the centre of managing the virus.
 
‘GPs are integral to healthcare – they’re the gatekeepers and they’re going to still continue to play a really important role because this pandemic isn’t going away anytime soon, unfortunately,’ she said.
 
‘The need for difficult risk communication has only increased since we conducted this survey as the vaccine rollout has picked up momentum.’
 
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