Dr Brenda Murrison reflects on life with COVID as a regional GP and practice owner.
Looking back on 2021, poor communication and a lack of guidance from authorities in general characterised the year.
Often the media has announced things long before anyone else told us anything at the practice level, and this has been confusing for patients and horrendous for practices to manage.
Being based in Bunbury, myself, and with a high number of our practices based in the regions, my concerns as a practice owner in the main have been around the safety of our teams and the communities we live in and they revolve around the following issues:
Intensive care beds – or lack of them. WA lags the national average with 8.5 beds per 100,000. Our staffed beds have dropped from 179 to 159 during the last year but we do have surge capacity for 300. Cold comfort I’d suggest. If you live in the regions, you are an awfully long way from intensive care beds.
Rapid antigen testing (RAT) – here in WA we are in the unlucky position of being one of two States who cannot have a licence for RAT in our practices. We need this resource to manage safely moving forward to 2022 when we will have COVID in our community.
Vaccination – rates in regional and rural WA have lagged the cities in a fairly spectacular way, which is indicative of the fate of rural and regional health in general. If vaccination is the pillar of our response, how could we have got this so wrong? The rollout has been a debacle, poorly coordinated and financed, the reality being it has been loss-making to be involved in the vaccine rollout for many practices.
Fortress WA – yes, we have loved the “bubble” but life can’t go on like this. We need to learn to live with COVID in our midst. The fortress has protected us to allow vaccination rates to get up to an acceptable level to open, but has also been our biggest foe – we cannot get skilled workers into the country inclusive of doctors, and several of our doctors are stranded overseas unable to get back in.
Mandatory vaccination and exemptions – as an owner GP, I was relieved when vaccines became mandatory as it’s a victory for common sense that should have come sooner in reality. Like all GPs, we are starting to see the people who are anti-vaccine start to book in for appointments for exemptions, but with so few true reasons for these, very few will qualify to get them. It certainly is exhausting explaining over and over again why we can’t oblige.
Clean air – HEPA filters, carbon dioxide monitoring (hello aloe vera and mother-in-law tongue plants), ventilation. All the new things we will need to think of in a consulting room moving forward.
The fundamentals – point of care testing, environmental cleaning. waste management, PPE, N95, fit testing, social distancing, scrubs, hand sanitiser.
Funding of our services in an outbreak – what will be MBS and what will be State-funded when we are caring for large numbers of patients in the community? What will be expected of us as GPs, as we care for patients with mild, moderate and severe COVID in our communities?
Burnout – stressing that staff aren’t taking enough leave to rejuvenate and then worrying about what will happen post-pandemic when lots of people want to take leave at the same time.
Planning, planning, planning – trying to keep a step ahead at all times and to predict as best we can what might come next. We are indeed in the lucky State in the respect that we have watched and learned from the eastern states and their experience.
From a personal point of view there have been a lot of additional pressures in dealing with the media, and not a week has gone by without a radio, TV or newspaper calling. After a while, particularly for the issue of vaccine hesitancy, it’s hard to think of more to say to try and persuade people to come in and get the vaccination done. How many lockdowns will it take, or will it be the ambulance sirens increasing that will make the difference?
Life has had to go on, with my eldest daughter starting university, and my youngest kids having school, sport and music as normal. My husband’s 50th birthday was postponed as friends couldn’t get here from the eastern states. Add all the challenges that everyone else has endured this last year.
And like many of my colleagues in the regions, I’m an international graduate originally, so the perils of distance, the inability to have family visit as they would do usually, has been hard. Knowing that in the event there was an emergency I will be able to get there, but goodness knows when I might be able to come back to WA again.
And then back to work again. Prepare, plan, pivot, refine. Repeat.
Welcome 2022!
ED: Dr Murrison is founder and CEO of Brecken Health Group.