Dismay at claim half GPs’ work could be done via telehealth

A Te Whatu Ora/Health NZ boss says up to half of all GP work could be done via telehealth, including doctors based overseas.

The agency’s Living Well director, Martin Hefford, spoke at the conference Building the future of health hui this week, a regular webinar to update healthcare professionals, and anyone else interested, on the work of Te Whatu.

Hefford said the “medical cavalry” would not come to lift the country out of the shortage of general practitioners, which was predicted to rise to 1,000 by 2033.

About 40 to 50 percent of GPs’ work could be done through telehealth consultations, he said.

“We are not going to be able to train enough doctors to meet the GP shortage that we are predicting and we need to look at other ways to manage access and manage health issues and demand,” he said.

Telehealth is when patients have appointments with their primary care doctor via video or phone calls.

Because the location of primary care doctors did not always coincide with where the need was greatest, telehealth could give more people access to care, he said.

And help could also come from outside the country.

“It’s a great opportunity to balance demand in rural areas, demand in areas with very deprived populations, with people who could be operating from anywhere in New Zealand or anywhere in the world, as long as they are trained or accredited in New Zealand. Zeeland”. he said.

A leading GP group said it was “dismayed” by the comments.

Deliberate underinvestment

General Practice Owners Association president Angus Chambers said this showed Te Whatu Ora did not understand the work of GPs.

Telehealth was a great complement to general practice for matters that didn’t need face-to-face intervention, but there was other care that could only be achieved by being in the same room with someone, she said.

That included “opportunistic attention,” he said.

This was where doctors might notice another problem or take the opportunity to talk to their patients about an issue they hadn’t gone to the doctor about.

He was also bothered by Hefford’s suggestion that non-medical roles play a larger role in clinical care, such as nurses, healthcare assistants, physiotherapists and health coaches.

“This is yet another example of Te Whatu Ora misinterpreting and undervaluing the work of GPs. Mr Hefford also claimed that 20 per cent of general practice work could be carried out by physiotherapists. This is simply ridiculous and assumes that the diagnosis has somehow been achieved without a family doctor,” he said.

cameras said Control telehealth was the “second best option” for many conditions.

He questioned whether Te Whatu Ora was deliberately underinvesting to address the GP shortage.

“We’ve been warning about labor shortages for decades and they haven’t really done anything about it.

“It is well documented that they have not covered the increased cost of providing healthcare and we are on the verge of losing our GP services and number of areas.”

Telehealth was not a cheaper option in the long term, he said.

People with regular access to a GP cost the system less and live longer, he said.

“One might wonder if the system doesn’t want people to live longer because they cost so much more once they’re over 65, but that might be a cynical view.”

However, he said telehealth was useful for people living in remote areas.

It worked during the Covid-19 pandemic, but people flocked to clinics once they could “because they actually like human contact,” Chambers said.

Hefford said there were 21 million “GP engagements” in New Zealand last year.

About 5 million New Zealanders, or 96 percent of the population, were enrolled in a clinic.

But for the rest there were still barriers to care, such as being able to get an appointment or not being able to afford to go.

Work had to be done to break down those barriers and find new ways to ensure everyone got the care they needed as the number of doctors dwindled.

However, Health New Zealand said greater use of telehealth services would “free up” GPs to focus on complex patients.

National primary care clinical director Dr Sarah Clarke said the agency was working hard to boost the GP workforce with additional funding and training places, but there remained a critical shortage.

“Despite our best efforts, we still do not have enough GPs and we will need to work together as a system to redirect some of the tasks that GPs perform so they can focus their time on the complex care best performed by our valued staff. GP workforce,” he said in a written response to RNZ.

“We know that continuity of care in general practice is important and that being with the same provider for at least 15 years significantly reduces the risk of death, the need for out-of-hours acute care and hospital admissions. In a model where you know your patient, continuity can be maintained while providing much of the care via telehealth, as is already happening across Aotearoa.”

Many clinics were already providing a host of services via telehealth, such as allowing patients to check test results or order prescriptions online, he said.

“We use telehealth every day as it is a way to deliver quality care that is efficient and convenient for people, their whānau and communities.”

Te Whatu Ora defined “telehealth” in this broader sense, not simply video or telephone consultations, he said.