Documentation demands are no longer preventing  problems, they’ve become the problem. That’s the findings of The PHOnetic this week after we caught up with provider staff who are losing their patience and losing the fight with the bureaucratic beast.

As practice manager and head nurse at The Village Clinic, Jo Rogers knows firsthand the pressure bearing down on her and her staff. 

There’s always the stress of caring for ill patients, but it’s the stack of paper work that really fuels frustration.
“I don’t know how some people do it,” says Jo. “I have been here today doing purely bookwork for follow up for re-accreditation, and it’s huge.”

Like all health professionals Jo and Village Clinic general practitioner Murray Smith did not go into primary health care to do paper work. But they are increasingly being forced to choose paper work over patient work as the documentation demands on health care spiral out of control.

“How petty are we getting?” asks Murray, who freely admits to feeling overwhelmed by the demands. 

“To comply with the requirements we have on us now is basically impossible. To do things in the same way as the Health and Disability Commissioner’s office expects, we really have to allow 30 minutes for each consultation.”

At just a glance, the administrative burden in general practice includes paperwork for payment, plus various electronic and hardcopy documentation for patient records, patient assessment tools, and care plans. Government agencies enact regulations that affect general practice and many of those demand duplicative paperwork. Insurers, ACC, accreditation groups and other agencies add to the pile.

A snap shot this week will see most practices preparing for reaccreditation, continuing their Quality Plan reporting, whilst still reeling from the Code of Rights and patient privacy reminders. And all of this on the back of a recent enrolment audit.  

It’s excessive, says Desmond Road Medical Centre General Practitioner Dave Somerton who expressed his vexation during Pinnacle’s medico-legal training this month. 

“The clinical work, the bit we all enjoy doing is getting swamped with all the reporting. We have a smaller workforce trying to do more complex work, and more of it.” And that will lead to burn out, he says.

While clearly there are valid regulations and paperwork that are needed to preserve quality and ensure proper payment, everyone The PHOnetic spoke to said overregulation was leading to job dissatisfaction. It’s driving some of them out of health care, believe Murray and Dave.

According to Dave young doctors are “voting with their feet” and turning away from the profession. It’s a shame, says Murray, who believes if the younger doctors took a stand, then maybe change could happen. 

A younger Murray, someone not working 14-hour days and catch-up hours in weekends, might have given it a crack. 

“I’m too old for it. You know it’s not going to change anything. I think it will make general practice a very unattractive option in the future. We don’t want to end up like the States.” 

At Kaiti Medical Centre Lynn Jenkins was just starting to get her head around Aiming for Excellence, the Cornerstone reaccreditation standards. She’d been warned that some of the standards were new and she expected to do very little patient work over the next month as she opened cupboards and folders in preparation for the auditors’ visit.

As well as the development of a new policy encouraging a  healthy workplace, there is also a workplace goal encouraging the practice team to consider becoming a ‘healthy action practice’. Lunchtime walks and healthy food for practice events are suggested.

Murray Smith hopes soon the pendulum will swing the other way. 

“It’s bizarre, and it’s not solving anything.”

Swimming the English Channel is just one goal of Turanganui Primary Health Organisation’s newest board member Diane Cooper.

Diane joins the 8-strong Board as a community representative and brings with her a drive and determination for helping organisations achieve their business and strategic goals. 

Her own personal goals on the other hand, are a little more...quirky!

“Seriously! I have always wanted to swim the English Channel but I think I will wait and do it when I can take the title of being the oldest swimmer to cross.”

As well as a long distance swimmer, Diane is a self-employed business advisor with a wide range of clients including some in mainstream and alternative health. She’s looking forward to her new role.

“I am very interested in health and what is happening. I am quite keen on people having more choices and I think PHOs are very involved in that.”

Diane is a chartered accountant and grew up in Gisborne. She has returned to the city periodically during her working career.  During the mid-to-late nineties she lived in London running her own business and marketing consultancy organisation. 

Diane replaced former community Board member Tracey Tangihaere. She was one of seven to apply for the role, and was interviewed by Keriana Brooking and David Scott. 

David, Board Chair, said the current economic climate coupled with the need for the PHO to maximise the tax payer’s dollar, meant a person with accountancy, commercial and business experience would be invaluable. 

“In 2008 we reviewed the skills and experience of the then current Board and identified gaps. Diane had the expertise we were looking for. She will be invaluable when assessing and evaluating presented contract projects.”

Diane and husband Neil Cooper are looking forward to returning to Gisborne in the next few weeks following a six-month stint in Hawkes Bay. 

A strong swimmer since her youth, Diane swam competitively for five years representing Hawkes Bay Poverty Bay in the New Zealand champs. 

She cemented a passion for long-distance swimming when she joined a group called the Durham Masters and took part in events where swimmers accumulated their training swim distances so they could claim a circumnavigation of the world. 

For the record, the oldest verified swimmer to cross the English Channel is American George Brunstad, who was aged 70 years and 4 days when he crossed in August 2004, taking 15 hours 59 minutes. 

When she is not swimming or planning for her Channel crossing (!) Diane is a keen walker and an opera buff.

Turanganui PHO is governed by a Board of eight directors. Three represent Pinnacle (Dr Ken McFarlane, Dr Tom James, and John Macaskill-Smith). Three represent Turanga Health (Pene Brown, Reweti Ropiha, and Albert Stewart), and two represent the community (David Scott, and Diane Cooper).

Turanganui PHO welcomes Diane Cooper, and also congratulates fellow Board member John Macaskill-Smith who became a father for the third time last week.