I have now completed my LIS1, previously called “rotation doctor”, in Tønsberg and will soon start as a GP in Valdres, where I come from. Since my time as a student in Tromsø, I have followed the health debate closely and talked to many experienced and newly established GPs. It is a gloomy picture of the situation being drawn. Unfortunately, it looks like I cannot have the life I want for me and my family, if I want to work as a GP. Now there will soon be a state budget for which many have had high hopes, but which, with the signals that have been sent, looks set to be a gigantic disappointment. Again. An expert committee will make some recommendations in April 2023. Hooray. From rampart to rampart Many patients may see the GP’s office as a health shop where the owner gets paid well for being open on weekdays between 8am and 3pm. But when the patient consultations are over, several hours of evening work often await the doctors. There are crises that must be followed up, inquiries from NAV and insurance companies that must be answered, blood tests that must be evaluated, and not least an unlimited number of digital instant messages from patients via Helse Norge that are waiting for a response. For every task that is cleared away, new ones flow in, like Sisyphus pushing up the rock that always rolls back down. Most GPs are motivated by good patient meetings, but stifled by office work. As LIS1, you are spared a lot of this, but I know what I have in store. Taking good care of my 800 patients will alone correspond to at least 120 percent of the position. In addition, I am obliged to attend emergency calls, which I really like very much, but which in Valdres corresponds to almost 50 per cent of the position. It’s evening, night and weekend. 55 hours a week – that’s the reality. You often work from 8-15.30 at the doctor’s office, then hurry on to the same job at the emergency room from 16-23, before getting back to work at 8 the next day. Unjustifiable conditions GPs usually have a full working day before night shift as well. They get tired and often sleep too little. Such conditions impair any person’s cognitive function, and many emergency room doctors have probably performed their duties in a condition that corresponds to a blood alcohol level that is illegal to drive with. On my last Saturday night shift I tried my best to deal with drunk people with head injuries, mentally unstable people who wanted to die, cuts that needed stitching and sick toddlers with their worried parents. At 7.30 I am sitting completely exhausted with the island crossed in front of the PC and am going to write a report of concern to the Child Protection Agency. It didn’t turn out well. And I hadn’t even worked during the day at first. I don’t even dare to think about how many messages of concern have NOT been sent because GPs and emergency room doctors have not had the time or capacity to understand and handle all the situations they find themselves in optimally. And if you make a mistake, you’re on your own – then it’s your responsibility, your medical license, your shame. “Ordinary people” suffer Ever since the co-operation reform came in 2012, the general practitioner corps in Norway has warned of ever-increasing work pressure. I just can’t believe that the authorities have not listened when the doctors have shouted so loudly and for so long? The Labor Party, which itself introduced the reform, should be more concerned than anyone else with preserving such an important pillar of our welfare state. Now they say it’s the “ordinary people’s” turn. Patients and doctors are all ordinary people, doctors are not superhumans. Will the celebratory speeches about improvement be reflected in the national budget? Down for the count Like other ordinary people, I myself have been exposed to mental illness, with two severe depressions during my internship. Two new children and a massive workload were too much for a new doctor, and one and a half years of service became four. Twice I have been on week-long stays at Villa Sana, the Medical Association’s own health service for doctors at Modum Bad. Here I have met other doctors who have “hit the wall”, “become burnt out” or who are just gasping to keep their heads above water. I think it was in the earliest team to hit the wall, but I was far from the first doctor on duty there. Health-hazardous profession Doctors have long been alarmingly over-represented in suicide statistics. To think that this has nothing to do with the workload is extremely naive at best. It is a maddening paradox that the GPs themselves, without hesitation, would recommend patients in such a health-damaging work situation to change pastures. The faster the better. The capacity of Villa Sana is bursting at the seams, the waiting time is record long, and most GPs are asking for help. Stay rich and healthy! And then there was the Center Party, how can they live with District Norway suffering the most during the GP crisis? Now people are also struggling in central areas, but many municipalities and patients on the outskirts have lived for years with expensive substitute relays and poor follow-up. This affects those with chronic somatic and psychological disorders the hardest. And how can SV, which in practice approves the state budget, live with the fact that this situation only accelerates social inequality in our country? Private offers are flourishing, the rich and resourceful get quick help, while those who need it most barely get what they are entitled to. Expensive short-termism State Secretary in the Ministry of Health and Care, Ole Henrik Krat Bjørkholt, has indirectly announced, with a so far commendable initiative, that the state budget will disappoint GPs. The global economy requires austerity, so they must not expect too much. A strange line of reasoning, all the while the GP crisis is costing more and more with each passing year. The money is already gushing into the sea, due to overburdened emergency rooms and hospitals and temp agencies that vacuum the municipal coffers. In 2021, Norway’s municipalities spent an extra NOK 813 million on the GP scheme. No country in the world has the opportunity that Norway has to invest long-term in good health services, even in bad times. These are measures that, from a socio-economic point of view, will pay off enormously in the long term. The patients are the losers I, like many young doctors, am not willing to let the GP job play the main role in my life, while the people I care about the most are reduced to extras. If I have to become an internet doctor for a commercial player in order to achieve a healthy balance between work and leisure, yes, I will. A grim scenario, when my greatest wish is actually to have a normal job as a GP and emergency doctor in the village. Then the GP scheme just collapses around me, while the responsible politicians scratch their heads and wait for answers from yet another expert committee. The medical students have long since realized that they should steer clear, fewer and fewer of them will become GPs. Last breath So, Jonas Gahr Støre and Ingvild Kjerkol: why on earth don’t you do more? And why don’t you do it faster? You have been on duty for a whole year now. The patient from the previous shift is the GP scheme, and has been in the waiting room since their last shift ten years ago. The GP scheme has cancer with spread. It has been thoroughly investigated and there is effective treatment, but those of you who are on guard will still only take more blood tests, more CT images and more high-tech tests. The patient’s illness has now spread to a life-threatening stage, and yet you choose to investigate further without starting effective treatment? Due to their paralysis of action, all the country’s patients must now prepare to say goodbye to the GP system. A good friend who unfortunately died far too soon.
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A farewell to the GP scheme – Statement
