One in four patients did not see a GP when they needed: AIHW

‘I’m surprised at how many people don’t access GPs when they feel they need to.’
 
That is Professor Dimity Pond, University of Newcastle Professor and GP, speaking to newsGP about a new report from the Australian Institute of Health and Welfare (AIHW).
 
Coordination of health care: Experiences of barriers to accessing health services among patients aged 45 and over detailed the experiences of patients who had seen a GP between November 2014 and November 2015.
 
It found that an estimated one in four (24%) of patients aged 45 and older reported there was a time when they felt they needed to see a GP, but did not go. Half of those said the main reason was not being unable to get an appointment when needed.
 
That finding, in particular, surprised Professor Pond.
 
‘I think that speaks to the shortage of GPs, really,’ she said.
 
‘There’s only so much you can do to create spaces for appointments – that also delays [patients] – and we do have a shortage of GPs.’
 
Professor Pond said many general practices would benefit from having at least one extra part-time GP to ‘soak up’ some of the increasing demand.
 
She said her own general practice clinic is meant to be open on Saturday or Sunday afternoons, but often has to close due to inability to find an available GP.
 
‘And there’s lots of practices like that,’ she said.
 
The flow-on effect of patients not being able to see their GP when they need to is multi-fold.
 
‘If people don’t go to the GP, either they go to the emergency department, which is not a great place for chronic disease … or else they just don’t get their regular check-ups, and that’s a problem because that’s how we manage and prevent problems with chronic disease,’ she said.
 
‘So it’s very important.’
 
The AIHW data also revealed that one in eight (13%) patients aged 45 and older reported there was a time they needed to see a specialist but did not go. Furthermore, patients who needed to use health services the most were more likely to not see a GP or specialist when they felt it was necessary.
 
The data revealed that, in 2016, patients with high health needs were more likely than those with low health needs to report there was a time when they felt they needed to see a GP but did not go (31% versus 19%).
 
Even so, the report found that patients with high health needs had more GP visits on average (13.8 per person), compared to patients with low health needs (4.6 per person).
 
Professor Pond is particularly concerned that patients with high health needs were unable to access an appointment with their GP.
 
‘Chronic disease management should be ongoing – at least the [treating doctor] should have access to the notes,’ she said.
 
Living in a remote or very remote area was also an impediment to seeking healthcare, the AIHW found. The proportion of patients who said they did not see a GP or specialist because there were no health services nearby rose in accordance with increasing remoteness.
 
Patients in remote and very remote areas were 8.2 times as likely as those in major cities to report that not having a GP nearby was a reason for not seeking care when needed.
 
Such patients were also 24.4 times as likely as those in major cities to report that not having a specialist nearby was a reason for not seeing a specialist when needed.
 
Professor Pond believes the important takeaway from this new data is the need for more GPs.
 
‘We know that general practice is no longer a popular choice for medical students,’ she said.
 
‘Some of it is around remuneration. If you graduate with a huge HECS debt, you don’t want to be working in the lowest paid bit of the health service.’
 
Another contributing factor lies in the inherent challenges of being a GP.
 
Professor Pond said the current coronavirus response by GPs highlights the need of having to adapt one’s practice and engage in a public health response while triaging patients and potentially putting your own health at risk.
 
‘It’s challenging, it’s not simple. We’re at the frontline, really,’ she said.
 
‘So it’s a complex issue.
 
‘I don’t think we [as GPs] realise how many patients can’t get in.’
 
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