A national shortage of medical specialists means some regions are going without entirely, and others are rejecting up to a fifth of all patient referrals.<\/p>\n
There are 44 actively practising specialist physicians for every 100,000 people in New Zealand, compared with 66 per 100,000 in Australia, according to the Royal Australasian College of Physicians (RACP).<\/p>\n
RACP New Zealand president Associate Professor Janak de Zoysa said many were exhausted and burnt out.<\/p>\n
It meant only 61 percent of patients received a first specialist assessment within the recommended four-month timeframe in the most recent reporting period – well below the government’s 95 percent target.<\/p>\n
Many patients had their referrals rejected, and were never seen by a specialist, with referral rejection or non-acceptance rates reaching around one in five in some districts.<\/p>\n
The college is calling for a 10-year National Health Workforce Plan which crosses electoral cycles, and work to build a sustainable specialist workforce through investments in training, support and retention.<\/p>\n
It is also calling for stronger rural and regional training.<\/p>\n
While 16 percent of New Zealanders live in rural areas, only one per cent of RACP physicians were based there.<\/p>\n
Two-thirds of RACP physicians and trainees are based in Auckland, Wellington and Canterbury, while some regions have only a handful of college members – de Zoysa describes these areas as “specialist deserts”.<\/p>\n
The West Coast has just three, Marlborough 11 and Tasman 20, leaving many regional communities without timely access to specialists.<\/p>\n
It was often up to the patient to travel to the nearest specialist.<\/p>\n
Retention was also an issue. International medical graduates made up nearly half of New Zealand’s medical workforce – one of the highest proportions in the OECD.<\/p>\n
Only 28 percent remained in New Zealand after five years, compared with 85 percent of doctors trained locally.<\/p>\n
According to the RCAP, only half receive a formal induction into the health system, and just three percent report receiving any meaningful orientation.<\/p>\n
“They don’t feel valued and they don’t feel supported,” de Zoysa said.<\/p>\n
“If we can make that investment in people and hang on to them, that’s 30 years of a trained specialist who will provide care to literally thousands of people.”<\/p>\n
Another aspect was pay. “I’ve been working as an internal medicine specialist for over 20 years and my salary is less than a junior consultant starting salary in Australia,” said de Zoysa.<\/p>\n
Gastroenterologist Dr James Irwin recently resigned from his position at Palmerston North Hospital, where he was the last one left<\/a>.<\/p>\n