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GPs outraged at suggestion of inadequate expertise
GPs have expressed anger and disbelief at ‘offensive’ claims they are not sufficiently skilled to provide end-of-life care.
RACGP President Dr Harry Nespolon called Martin Pritchard’s comments ‘offensive’.
WA Labor member Martin Pritchard last week questioned whether GPs are up to the task in a debate over his State Government’s plans to introduce voluntary assisted dying legislation.
‘I cannot believe that it could be appropriate for a person to say, “I’m going to die in six months. I should take advantage of voluntary assisted dying”, based on the advice of a general practitioner,’ he said in Parliament.
‘With all the respect in the world for general practitioners, there are some who specialise, but the vast majority are the doctors down the corner that people go to for some cough medicine.
‘The vast majority are generalists … I am not sure that a general practitioner in the backlots of the regions would have the ability to provide the closest prognosis possible when it comes to things outside their area of speciality.’
Mr Pritchard also said he does not think he would accept a GP’s assessment that he had four months to live due to cancer.
Mr Pritchard did go on to say he had no concerns about the coordinating doctor in an assisted dying case being a GP, and said he would prefer a GP who had a relationship with the patient to play that role.
But the comments sparked a strong response from RACGP President Dr Harry Nespolon.
‘These offensive comments show how out of touch Mr Pritchard is with modern general practice,’ he told newsGP.
‘The experience in Victoria has been that GPs are the backbone of putting into action the legislation.
‘Mr Pritchard fails to understand how many hours are required with patients and their families in this situation – even the patient and families who are just considering accessing voluntary assisted dying.
‘He is mistaken. GPs are specialists and the specialty of general practice is about the whole person, not just an ailment or particular body. They are not there to simply dispense cough medicine.
‘GPs working in the CBD of Perth, Albany, the Pilbara or – as Mr Pritchard himself describes – the “backlots of the regions”, provide complex, holistic and patient-centred care.
‘GPs apply their sophisticated skills in diagnosis and prognosis and an intimate understanding of a patient’s medical history and life circumstances to determine the best care and treatment. This includes coordinating care with other doctors, such as palliative care specialists.
‘I recommend Mr Pritchard visits his local GP and talks to them about the myriad complex clinical presentations that they manage every day before commenting on the role of general practice any further.’
RACGP WA Chair Dr Sean Stevens has also called on policymakers to remember that GPs are ‘recognised specialists in whole-person, patient-centred’ care.
‘GPs provide a range of specialist medical services for patients at all stages of life, and are well equipped for end-of-life care. Recognising and supporting the role of GPs is central to meeting society’s growing need for high-quality end-of-life care,’ he told newsGP.
‘GPs are experts in not only diagnosis and treatment, but also prognosis. Assessment of life expectancy for the purposes of voluntary assisted dying could be appropriately done by two GPs, with reference to a medical practitioner sub-specialising in the disease if deemed necessary.
‘It is also important to remember that arrangements for end-of-life care need to work for all people across Australia, not just those in metro areas.
‘GPs are the backbone of the healthcare system, including end-of-life care, and are often the only medical specialist in rural and remote communities.’
The controversy comes as WA debates the role of doctors in its proposed assisted dying legislation.
The legislation this week overcame another crucial hurdle, passing a preliminary vote in the state’s upper house. The laws passed the lower house in September.
Under the proposed laws, terminally ill patients over the age of 18 in pain with less than six months to live – or one year for those with neurodegenerative conditions – will be able to apply to access to a substance to end their lives.
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