Rural GPs struggle to survive

Dr Alex Michel.

Rural doctors are struggling like never before amid cuts of 38% since the recession and a severe shortage of substitute doctors to allow them to achieve meaningful work life balance.

Renvyle GP Alex Michel said he can be on call for 106 hours a week and often works twelve days in a row due to the lack of locum cover.

He believes doctors in rural practices are hurting most of all due to the Fempi cuts, introduced as part of a new contract for GMS (General Medical Services) patients who have free medical care through medical cards or GP visit cards.

The removal of distance band codes and rural practice grants has left a sizeable number of rural practices now insolvent. Many rural posts remain unfilled because GPs no longer see setting up in villages and small towns as an attractive proposition.

In their submission to the Government to negotiate a new contract, the National Association of General Practitioners (NAGP) argued that rural practices cover much larger geographical areas than non-rural practices and have more socio-economically deprived patients than those in cities or towns.

As a result, the vast majority of their practice is reliant on GMS patients for whom doctors receive a single payment per patient regardless of the number of visits to a GP.

Dr Michel, a German native who has worked around Ireland for 17 years, seven of them in Renvyle, said it was now very difficult to provide best service to his patients. He has considered leaving the country due to the financial strain and work burden.

“My workload is much greater than ever before due to chronic care diseases such as respiratory disease, diabetes and the aging population. I have to work holidays, weekends, travelling to patients 20 km either side of Renvyle, covering an area from Cleggan to Leenane,” he explained.

“I work on my own – occasionally I have a locum doctor helping me a day here and there, but in the last year I could not have a proper family holiday during the summer because I couldn’t get a locum.”

See full story in this week’s Connacht Tribune.