The extremely high pressure under which GPs work, in addition to staff shortages, means an overload for general health care in the Netherlands. Running extra shifts and not being able to take a holiday are examples of how the situation is getting out of hand, which makes the GPs concerned for their patients’, their own and their teams’ well-being.
Recently, the LHV (National Association of General Practitioners) surveyed 1,100 general practitioners: three quarters indicated their workload is too high. According to the LHV, the number of participants is a good reflection of the 13,000 members of the GPs Association. This study by the LHV also showed that two thirds of GPs have difficulty finding replacements, and half of them have less energy than before the corona pandemic. LHV chair Mirjam van ‘t Veld expressed that “there are hardly any opportunities to recover. We must break this negative spiral if we want to keep general practitioner care accessible.”
“While the survey showed that GPs are proud of their resilience and that of their teams, they unanimously express their fatigue and concerns for the future,” says Van ‘t Veld. “The general practitioners and their teams are at the basis of healthcare in our country, they have a close relationship with their patients and know their context and environment. We call on politicians and other partners to help the GP to safeguard that basic element.”
A first problem raising the pressure for GPs is that they have taken on a lot of the Covid vaccination campaign – several groups of patients were vaccinated by their GPs, rather than by the GGDs, the regional health authorities.
Secondly, a lot of patients come in with accumulated complaints that need catch-up care, since they delayed coming after the pandemic started. This makes practices much busier than usual. Furthermore, GPs are facing staff shortages, which add extra pressure to the work overload. Katinka Prince, a member of the Amsterdam General Practitioners Alliance, explains that staff shortages are urgent in the whole healthcare sector, not only GP practices. This creates a continuous cycle: when a patient receives a referral from their GP for specialist health care, for example, they will have to wait a long time to be seen, because specialist care institutions are also low on staff. This in turn causes more work for the GP, who has to make multiple calls in order to find a place to refer their patient to. “It’s a problem in mental health care, in-home care, in hospitals. So if you want to refer a patient to a psychiatrist, or if you want to request home care for someone, it takes a GP a lot of time,” said Prince.
Another reason for staff shortages, especially in Amsterdam, is that there are many employees with cold symptoms, so the possibility of it being Covid has to be considered. This means employees have to take time off work until the get a negative test result. With the existing staff shortages, finding substitute GPs is challenging.
Long-term solution wanted
Van ‘t Veld thinks that ultimately the government is responsible for finding a long-term solution. She feels that removing the task of large-scale vaccination campaigns from the GPs is step one. This would mean that the GPs would still take care of the yearly flu vaccines, but that boosters against Covid would be taken care of by the GGD.
She also thinks that the time a patient spends at the doctor should be sufficient for both to explore the underlying problem. More time would lead to better care and eventually fewer hospital referrals, less medication use, and ideally greater job satisfaction for GPs. In the meantime, Van ‘t Veld enhances people to require their GPs assistance if needed: “Please don’t avoid the GP; it will only lead to more delayed care, and it will have to be caught up at some point.”
In general, GPs are not optimistic about their ability to provide excellent and valuable patient care in the foreseeing future. The government needs to act at once to reduce the administrative burden that practitioners and their teams are facing.
Written by Bárbara Luque Alanís