Out-of-hours service an added source of stress for GPs who are already under pressure, says Cork doctor

Out-of-hours service an added source of stress for GPs who are already under pressure, says Cork doctor

Dr Mike Thompson said that in addition to his GP practice weekdays, he often works on Saturday and Sunday in SouthDoc and that this is not healthy. Picture: Gerard McCarthy 

A CORK GP has spoken out about the pressures that general practice is under and how SouthDoc is an added source of stress for GPs manning the out-of-hours service.

Midleton-based Dr Mike Thompson highlighted how GPs are now expected to always be on call or on duty.

He also raised concerns about issues coming down the line, in terms of staffing.

Dr Thompson said that while people are “delighted” with the SouthDoc service, as it means they can be seen sooner than they would be by their GP, he works 14 hours on Saturday and Sunday, on top of his normal weekday hours in his practice.

Dr Thompson said it is “not safe”.

“If I was a truck driver or a pilot, I wouldn’t be allowed to do it,” he said.

He sees as many patients as he can in a day at his practice, and attends to phonecalls, so he often works until 7.30pm or 8pm.

“The thing that suffers then is your physical and mental health, and your family and relationships.

“You need to have a healthy GP. You need to have a refreshed, healthy doctor.

“We’re the same as the rest of the population. We haven’t had a break or a holiday, but we’ll get over that,” he said.

Dr Thompson said that while there will always be a few spare appointments when he starts in the morning, the majority of GPs are booked out.

“You have whatever crops up during the day, then, also, you’ve got the emergency house call, for example,” Dr Thompson said.

“That’s the one thing about general practice: It’s unscheduled and atypical, because there are no two days the same.”

GPs who want to work the out-of-hours service, on top of their working week, should sign up to an enhanced contract, “unlike the 51-year-old contract I work off, which is older than I am and which came in at a time when there weren’t even phones, not to mind mobile phones”.

“Most people didn’t have a car. It was a case of being contactable. Nowadays, people have this perception that you’re on call or on duty,” Dr Thompson said.

Speaking about how GPs should triage the calls coming into SouthDoc to prioritise the most serious cases of illness or emergency, he said that, “sometimes, SouthDoc’s agenda is not the same as the GP’s agenda”.

“Sometimes, what patients want and what they need is, unfortunately, not the same thing.

“I always say you can have good, cheap, or quick, but you have to pick two.

“I sometimes think there’s a little different perspective and prerogative when you talk about SouthDoc.

“About 3% of SouthDoc calls were house calls and, ultimately, SouthDoc should really only be for house calls, or maybe someone who got a bad cut, or a very sick child.

“But, just to have an overflow clinic from your day is farcical and dispiriting.

“The difficulty is for the nurses triaging it: Are they going to say ‘no’ to a two-year-old who has got a cough? I don’t think they will and I don’t think they probably should; maybe those parents did ring their GP at 9am looking for an appointment.”

Dr Thompson predicts GPs taking a step back.

“What will happen is that people will just pull back from 24/7 care and then that’ll be up to the HSE and that will be just, basically, accident-and-emergency (departments), who are under pressure, in fairness to them,” he said.

Dr Thompson said the health service is also dealing with “a newer breed of GPs, who are far more in tune with work-life balance and self-care and burnout”.

“I genuinely don’t know how it’s [the issues] going to be answered.

“It’s a pity, because it’s a lovely job.

“It’s a great career and I think the day job is controllable — you can put your own control on what kind of GP you want to be — but come out-of-hours, it’s the wild west,” he said.

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