General practice: survival by adaptation

To the Editor: My compliments on the issue of the Journal on the survival of general practice (20 July 2009). But something was missing — a patient’s perspective.

I hear from fellow Sydneysiders that they cannot find a general practitioner offering continuity of care. They tell me that:

• All recommended GPs have “closed books”.

• They can’t get an appointment on the day and have to wait until a few days later, unless it’s a “real emergency”.

• At big, “commercial” practices, they seldom see the same GP again — and must tell their story each time.

• Their GP (preferably female) is there some weekdays only.

• They can’t find a GP who does home visits.

• Neither “their” GP, nor any of the others in the practice, is available after hours — they must ring an emergency doctor with no access to their records.

• GPs want them out quickly with a prescription or referral.

• GPs say that, although it’s a simple procedure, it’s better done by a specialist.

• GPs want to start a “care plan”, even if there’s nothing much wrong.

• They’re not happy with attention from the nurse — they want to see the doctor.

And so it goes.

Back in 2006, the Australian Consumers Association, together with advice on choosing a GP, commented: