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00:00:06
Speaker 1: You're listening to the Kerrywood and Mornings podcast from Newstalk ZB.
00:00:12
Speaker 2: A Rotorua GP who spent 44 years caring for local families has come out of retirement at 78 to help his daughter meet growing demand for health care. After seven years after hanging up his stethoscope, Dr John Armstrong has returned to general medicine with his daughter, Dr Tawa Armstrong. She had taken over the practice five months ago but was simply overwhelmed with demand. Tawa said she soon discovered with more than 6,500 patients on the books, the wait list to see a GP for routine visits was at an unacceptable four months. Dr John takes a break from patients to join me now. I appreciate it. Good morning, Dr John.
00:00:53
Speaker 3: Good morning, Kerry.
00:00:57
Speaker 2: I imagine that the other Dr Armstrong, Tawa, advertised for GPs, what is it about general practice that makes it so difficult to recruit new GPs?
00:01:11
Speaker 3: Good question. I'm not sure of the right answer, but general practice is not easy, you know, but it is a commitment. We haven't been training enough GPs. Hopefully that will change in the future. But yes, it's not easy, and particularly to attract GPs into a low socioeconomic area is difficult.
00:01:42
Speaker 2: Is that because there are concerns about accounts being paid or concerns about just the length of time it takes to deal with patients whose conditions are more complex?
00:01:56
Speaker 3: Well, certainly I think the conditions are more complex. You know, for those of us who are working in the low socioeconomic areas, the remuneration is not the issue. It's the care for the patients.
00:02:14
Speaker 2: Yeah.
00:02:15
Speaker 3: Yeah.
00:02:16
Speaker 2: And feeling like you can't give them the time that they need because there's somebody else knocking on the door.
00:02:24
Speaker 3: Yeah, that's true. You know, I mean, a lot of GPs... up and down the country doing maybe 15 or 20 minutes per consultation. And it's difficult when you have so many patients booked in to deal with the multitude of problems people come in with. And the other thing is that if people are not able to get in to see their doctor for three or four months, they not uncommonly come in with a list of issues. Yeah.
00:03:01
Speaker 2: When it comes to the corporatisation of GP practices, which we've seen, do you think that, in part, that has helped save more GP practices or is it a race to the bottom?
00:03:21
Speaker 3: Well, I think for me personally it has helped because when we owned the practice, it was... It was difficult to focus on the surgery surviving financially. So we ended up selling the practice to Pinnacle. And so that took a lot of pressure off my wife and I as the owners because sometimes the books would balance and sometimes they wouldn't every month. So that was a big stress for us. But yes, no, I think Pinnacle has been... Really good for our practice. And they're in the game because they care about people. And, you know, it was a good move for us anyway.
00:04:09
Speaker 2: Well, yes, I just can't imagine how some practices would have survived because you're working incredibly long hours and then you're going home and doing the bookkeeping. I mean, that doesn't work.
00:04:20
Speaker 3: No, no, it is difficult. And, you know, there'd be very few, if any, solid practices these days because in order to, one of the reasons for getting together into a group to provide the service is financial. You just can't survive because of the costs.
00:04:40
Speaker 2: When it comes to the three free or taxpayer funded GP visits for everybody, do you think that that is a good way of spending part of the health budget to or should it be more targeted to those who need it more?
00:04:59
Speaker 3: Well, I think any program that benefits people is a good idea. Benefits the majority of the population. I think that's fair. But having said that, there's no doubt that some people in the community need more and better access and more financial support to deal, you know, to cope or to be able to access the system because there's an inequity for a lot of people in not being able to have good access and good care because of the cost.
00:05:41
Speaker 2: With community services cards, you know, they exist for people who need a bit of extra help.
00:05:47
Speaker 3: Yeah.
00:05:48
Speaker 2: It would have been better, surely, to just make those free visits completely for those on Community Services Card, and if needs be, extend the Community Services Card.
00:05:58
Speaker 3: Well, yeah, I get that, but to me, I don't actually know how hard it is to get a Community Card, but I know a lot of our patients, and you must understand, too, that I've just come back into the practice and I'm not really aware of what the current situation is with Community Cards, but I know a lot of our patients... are not familiar with those sorts of things, about getting community service cards. Yeah. So I think it's a move in the right direction. And I think that, you know, we have to target health money towards those in the greatest need. And, yeah, and it's a step in that direction, I think. But having said that, I support the policy of making care... a certain number of consultations free to all people. But let's face it, a lot of people are struggling.
00:06:55
Speaker 2: Yeah, yeah, they are. When it comes to the future of general practice as an option, I wonder if the decline of all of those television programmes around GPs, where the GP was the central focus of the community, like Dr Finlay's casebook and Country GP and all those sorts of things, I wonder if Like there was a kind of glamorisation of the role, which did not represent real life, but it certainly would have made becoming a GP more attractive to a generation of young doctors. I wonder if the decline of those programmes has meant that, you know, they go for the more sexy kind of hospital surgery options than the GP practices.
00:07:36
Speaker 1: Yeah.
00:07:39
Speaker 3: That's an interesting question. Look, I don't know the answer to that, but what I do know is that, you know, people who know that their doctors care for them are very popular amongst the population.
00:07:54
Speaker 1: Yeah.
00:07:54
Speaker 3: And I think, you know, and I think that doctor-patient relationship is crucial to, you know, to good medicine and to people accessing care.
00:08:07
Speaker 2: And how is it being backed Dr. John, after seven years away? Has much changed in that time?
00:08:14
Speaker 1: Oh, yes.
00:08:15
Speaker 3: Significant changes, particularly with technology. And I'm still coming up to speed with that. As part of the medical council conditions for my return to practice, I have a supervisor, which is pretty intense at the moment. And that's the way it should be to make sure that I do get up to speed. But no, it's been a pleasure, actually. And I have to say, within the clinic that I work, which is a Māori health clinic, the staff are so committed to improving the health of their people. They're just joyous to be with, I have to say. You know, back in the day, we tended to work in silos. Doctors and nurses and others are doing their own stuff. But, you know, it's very much a team effort here. And it's been a joy for me to meet up with old patients who still register for the surgery and all that that goes with it. It's a privilege to be a GP and to be involved in people's lives and their highs and their lows.
00:09:20
Speaker 2: I'm sure they feel the same way. It's a privilege to have you back. Thank you very much for your time, Dr John Armstrong, who's come out of retirement because it's just so difficult to find a GP. He's at the Ofata Medical Centre with his daughter, Dr Tawa Armstrong.
00:09:35
Speaker 1: For more from Kerry Woodham Mornings, listen live to News Talk ZB from 9 a.m. weekdays or follow the podcast on iHeartRadio.