Kerry GP urges doctors to consider joining practices in rural Ireland
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A Kerry GP nearing retirement has called for creative thinking around recruitment for rural areas, saying he is caring for 1,400 patients since his partner retired.
Patients around Ireland are seeing delays as appointments for routine care are pushed out for two weeks or more. However, rural areas and urban deprived areas are particularly challenged.
Dr Brian O’Donovan said he loved working in Caherciveen, and urged people to consider country practice.
“It’s not clear why people don’t want to come and work here. It’s a chronic problem all over Ireland, and in other countries,” he said.
“Going back 20 or 30 years ago, it was very hard to get a job. There were lots of people applying for jobs and very few jobs, whereas now it is obviously the reverse.”
He has run the practice since his partner retired about five years ago, despite efforts to find someone. This led to treating a growing number of patients, including medical card patients under the HSE’s GMS list system.
“There’s more than enough work here for two people here,” he said. “My list is over 1,400 patients.”
Like other Kerry GPs, he is also working with Ukrainian refugees.
“You do need to be more than one person to make this work. There aren’t enough GPs now for the jobs available, so people can be selective as to where they can go,” he said.
The practice could support two GPs, Dr O'Donovan estimated, saying: “My list is now bigger than when my partner was here, it is busy.”
His concern is unless the patients are split between two doctors, it is “less likely” someone will come in.
There is no formal waiting time for patients as he does not offer appointments.
“I’m an open practice and have stayed that way,” he said. “You couldn’t offer appointments with this [number]. We see people any day.”
Test appointments can be booked with the practice nurse [his wife Cathy] or midwife.
One solution is to increase training places, he suggested, saying not all GPs can or want to work full-time.
“If people are doing less sessions, then it requires more people to do the same job,” he said. “That’s where you run into manpower issues.”
Dr O’ Donovan also said supports for rural GPs had increased significantly.
He has access to a local X-ray unit, with the option of sending patients to Tralee also.
“We’ve the community hospital in the town, and one in Valentia,” he said. “You might get called to road accidents over the years, but less now. The EMTs are so much better trained, people are getting stabilised, dripped and going.”
Most treatment is “in-house”, he said.
“I do minor ops,” he said. “And, perish the thought, I have done home deliveries but not for several years now, for babies who come unexpectedly. But now there is better antenatal care and forecasting so I haven’t done one in several years now.”
He sees other changes as “way better” now.
“If someone is down here now and gets a bad heart attack, we have air ambulance to a cath lab and the person is air-lifted,” he said.
He added: “Country practice is different, I like it very much. You can be working in here, and then you can be out on the beach moments later, or out cycling or whatever.”
The Irish College of General Practitioners welcomed a Department of Health review of general practice, launched on Monday. Medical director and Glanmire GP Diarmuid Quinlan said 500 to 600 GPs are likely to retire in the next three to four years.
“We are training 70% more GPs than we did six years ago, we face an expanding population and greater demand for GP services,” he said.