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GP crisis – – Not enough breathing

– It is a complete crisis, says GP Cuu Duong (48).

Dagbladet meets him with two colleagues, GPs Giti Sabalani (53) and Slavoljub Markovic (43).

Together with four other doctors, they run Romsås medical center in Grorud. Grorud is one of the districts with the highest infection pressure in Oslo.

Now GPs are sounding the alarm about what they experience as too much work pressure, imposed tasks and a large flow of patients who need health care. It will go beyond patient safety, they warn.

12 hours daily

Both Duong, Sabalani and Markovic say that they work over 12 hours every day.

– Lately I have been sitting long after the day is over, but even though I sit until half past seven in the evening, I will not be finished. There have been several nights where I have woken up at five in the morning and thought: “Should I just go to work and do the rest?”, Says Duong.

CONCERN: Duong says he has many worries and a constant feeling of not reaching out. Photo: Kaja Storrøsten / Dagbladet
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Taken over privacy

Giti Sabalani says that in recent years, many tasks have been transferred to GPs.

– We receive requests from the district, the hospital, home nursing and Nav. All those we work with expect answers back in a very short time. We need to take care of our patients and manage the medical center. It has been so much, and it has taken over privacy, Sabalani despairs.

All the GPs at Romsås medical center have reduced their patient lists, but that has not helped, she says.

STRESS: Giti Sabalani.  Photo: Kaja Storrøsten / Dagbladet

STRESS: Giti Sabalani. Photo: Kaja Storrøsten / Dagbladet
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– We feel too much pressure. I feel we are secretaries for the hospital, home nursing, the district and Nav – everything goes through us.

– Ticking bomb

Sabalani feels like she’s going with a ticking bomb that soon explodes.

– At some point I will forget an important detail with a patient, a blood test I will ignore, because I can not focus on the medical under this pressure. I would like to take care of the patients and give them good treatment, but I am drawn to things that nurses and others could do.

During the pandemic, the work pressure has been extra high, but Salabani emphasizes that the problems go further back.

Photo: Kaja Storrøsten / Dagbladet

Photo: Kaja Storrøsten / Dagbladet
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– Even though it has been much worse during the pandemic, the problems started before that. It got worse three years ago with digitalisation, she says.

– Guilty

Slavoljub Markovic believes that the situation will go beyond patient safety.

– Soon the GP scheme will come to an end. Most places are struggling to recruit good GPs now. I do not know why it is that the GP scheme has been pushed aside and not prioritized. It is a tragedy that the government is letting that happen, says Markovic.

He says that the situation has also gone beyond family life.

– I have two small children at home and a wife who works. I have to take care of the children after work, but I often have a very bad conscience for the children, because I have to spend time following up on corona patients, test results and answering Nav in the evenings. I do not have time to breathe.

FASTLEGE: Slavoljub Markovic.

FASTLEGE: Slavoljub Markovic.
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Received concern messages

Assistant district chief physician in the Grorud district, Shaista Anwar, confirms that they have received many reports of concern from GPs.

– There is a crisis situation among GPs in Oslo. Many have reduced their patient lists. There are far too many tasks assigned to GPs, and patients have many complex issues that take a long time.

It is not just the pandemic that has made the situation difficult.

– The pandemic was the icing on the cake and thus put even more pressure on GPs. More authorizations, ie increasing the number of GPs in the districts – is one of the most important measures because we need more resources, she tells Dagbladet.

FIXED MEDICAL CRISIS: Ingvild Kjerkol talks about a worrying disability doctor crisis. Reporter: Johannes Theodor Fjeld. Video: Anabelle Bruun.
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– Worrying

Minister of Health Ingvild Kjerkol tells Dagbladet that they are looking at the possibility that GPs can use other types of health personnel in their doctors’ offices.

– It is in the short term, but we have a GP crisis that is worrying, she says and continues:

– We have binding objectives in the Hurdal platform, so we will work on this. But what we are doing now is ensuring them access to other personnel and ensuring that they have tariffs that ensure that everyday work is as livable as possible.

The objectives Kjerkol aims at are the obligation to solve the GP crisis by “shortening the list length for GPs by increasing the basic subsidy per inhabitant and establishing new recruitment authorizations.”

Crisis the rest of the country

It is not only in Oslo that there are crisis situations.

More and more municipalities are struggling to offer GPs to the inhabitants, according to The Norwegian Directorate of Health.

In Trondheim, the situation is so demanding that the municipality last week declared that they have a temporary shortage of doctors, writes Nidaros.

In Fredrikstad and other Østfold municipalities, they are on the brink of a serious crisis. The flow of patients is so large that it is approaching unmanageable, states the head of collaboration between Østfold Hospital and the municipalities in the coverage area, according to Fredrikstad Blad.

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