News

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Fears potential ED specialist exodus to impact GPs

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With almost a third of emergency medicine specialists planning to leave clinical practice or the profession over the next decade, experts say GPs could be most impacted by the exit’s knock-on effects.
 
An Australasian College for Emergency Medicine Sustainable Workforce Survey of more than 900 emergency doctors has revealed emergency department overcrowding, bed block and staff shortages are key ‘stressors’ for the doctors.
 
It also found a ‘concerning increase’ in intentions to leave the profession within the next decade.
 
Dr Michael Bonning, who sits on the RACGP Expert Committee – Funding and Health System Reform, said a mass exit of emergency doctors would put pressure on primary care, along with all parts of the health system.
 
‘First and foremost, our health system is interconnected, so knock-ons like a loss of workforce in one area, affects other areas, including and especially general practice,’ he told newsGP.
 
‘The interface with emergency medicine is one of the most important that we have in primary care and in urgent care. It’s part of a spectrum of care that allows us to safely and comprehensively manage deterioration in the acute setting. 
 
‘It’s really important to have a functioning, well-resourced, and sustainable workforce in emergency medicine and the survey results point to significant trends in healthcare that I suspect are replicated across multiple specialties and for parts of it, including in general practice.
 
‘When emergency departments function well, they are also in a position to support patients who need care, and those patients are able to be seen relatively quickly with excellent clinical care, delivered in the right time frames, that generally allows them to get back to being at home sooner, and with a great management plan that assists general practice in keeping them in the community.’
 
Dr Bonning said patients are developing a better understanding of when to see a GP, versus urgent care and emergency departments, and ‘we are taking on that prevention role that helps to reduce pressures on urgent and emergency care’. 
 
‘We are getting better at helping people to differentiate which form of care they should be accessing, which means that we are using resources more efficiently and appropriately,’ he said.
 
‘That is one thing that we have to our advantage now that when someone needs to go to the emergency department, we are more certain than we used to be, that that’s where they should be going.’
 
The survey found that, when asked why emergency medicine specialists plan to reduce their hours of clinical practice, responses fell into five main categories, many of which will be familiar to GPs:
 

• Unsustainable workplace conditions
• Work–life balance
• Transition toward retirement
• Pursuing non-clinical work or other professional interests
• Allowing more time for exam preparation and meeting training requirements

 
A breakdown by age in the survey shows those aged 41–50 years most frequently cited unsustainable workplace conditions, including high workload, burnout and other workplace stressors, as the primary reason for intending to reduce their clinical hours.
 
The survey also identifies overcrowding in the emergency department and access block as the most significant stressors for emergency doctors, along with consistently elevated levels of personal and work-related burnout.
 
The proportion of respondents reporting incidents of verbal abuse, physical aggression and sexual harassment by a patient or carer also remains high.
 
Dr Bonning said this is something many medical professionals are also able to relate to.
 
‘This highlights the human capacity of medicine, because of working conditions, strained and difficult working environments, moral injury, burnout, fatigue, sexual harassment, physical violence and threats, all of those things in this survey, I would imagine are heard and felt by doctors in health systems everywhere,’ he said.
 
Associate Professor John Adie, Chair of RACGP Specific Interests Urgent and Emergency Presentations to Primary Care said we need our emergency doctors, and it would be unfortunate for all in the health system to lose them.
 
‘As far as I’m concerned, emergency specialists are super-specialists and I have so much respect for their training, their qualifications and the role that they have in Australia servicing patients, and supervising teams of medical professionals,’ he told newsGP.
 
He said he would encourage emergency physicians to explore other options where they can use their skills, such as in private emergency departments, or even urgent care centres.
 
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