General practice is becoming a "harder and harder job" for doctors, one Galway-based GP says.
It comes as the Irish College of General Practitioners warns that 2,000 doctors need to be recruited over the next decade to cover current shortages and vacancies created by retiring staff.
The group says many GP practices are unable to take on any new patients, with too few GPs to meet demand.
Speaking on The Hard Shoulder, GP Dr Brian Higgins said general practice may have been "slightly neglected" recently as it's traditionally been one of the most efficient parts of the health service.
He said GPs don't work for the HSE directly and are instead 'independent contractors'.
He observed: “We have a very, very old contract that has been relied upon.
"Then in the last couple of years there’s been an extension of extra work on that contract - that we’ve taken upon ourselves to manage, but has made the complexity and the work a little more difficult.
“Unfortunately, the more difficult it has become, the less attractive the profession has become. It’s a brilliant job and I love it… but it’s becoming a harder and harder job.”
He said you can't blame qualified doctors for choosing to work abroad or work in other, non-GP areas of medicine.
He observed: “You have to be able to look after yourself before you can look after someone else.”
'A lot of change'
Dr Higgins said the nature of GP work has changed and in the past local doctors would have had fewer appointments on a daily basis.
He said a lot of the changes in medicine have been for the better in terms of making things safer for patients.
However, he said the service offered by GPs has needed to become more complex and advanced as a result.
He said: “When patients come and see you in their practice, they’re hopefully going to get a really, really good experience and service.
"But that does mean you have a lot more commitment to being in your office, which means you’re less able to go on house calls or visit nursing homes.
“You start doing those things in your home or personal time… and when you eat into so much of that time that it’s affecting you or your family, you’re going to look at your life and say ‘OK, I’m sacrificing my own personal life for my job’. In any profession, we would encourage people not to do that.
“It’s about figuring out some sort of balance.”
Dr Higgins said some doctors can’t accept new patients as they can’t guarantee an adequate level of care.
He noted that long hospital waiting lists are a major problem - patients who have to wait a year or two for a procedure means are likely going to get sicker in that time, meaning they will need to go to their GP more frequently.
Despite that, he believes lots of changes can be made on a local level - such as new referral systems or community cardiac screening services - to make a big difference.
He suggested: “If you make enough of the small-scale better, overall you’ll have a huge change on the big scale.”
His own clinic, meanwhile, has hired a full-time pharmacist who can talk to patients looking for a prescription - offsetting some of the work that would otherwise fall on GPs.