Patients: GP accessibility pressured by COVID-19 measures

The COVID-19 pandemic has put great pressure on health care worldwide. Although the emphasis here was on hospital and intensive care occupancy, a lot has also changed in general practitioner care in the Netherlands. Research from the Department of General Practice and Elderly Care Medicine at the University Medical Center Groningen shows that patients felt that some of these changes had a positive effect on general practitioner care, but that accessibility to general practitioners and the continuation of regular care did come under pressure. The results were published in the British Journal of General Practice Open.
Doctor and patient

Compared to the situation before the COVID-19 outbreak, much has changed in family medicine. For example, there are more opportunities to do digital consultations and often more time is scheduled for a physical consultation. On the other hand, care for diabetes or asthma, for example, was frequently delayed. "General practitioners had to adapt quickly during the COVID-19 pandemic to ensure that both COVID-19 care and regular care could continue as well and safely as possible," said Maarten Homburg, general practitioner and researcher. "It is important to know how patients experienced these changes so we can learn from them in the future. What changes do patients like to see remain and what should we prevent instead?"

Accessibility and continuity

The study led by epidemiologist Dr. Lilian Peters, which interviewed patients from the north, east and south of the Netherlands, shows that there have been varying experiences with GP care in the Netherlands. Changes such as the increased use of digital consultations for simple problems and more time for a consultation with the GP were perceived as positive. Patients therefore like to see these changes continue after the pandemic. On the other hand, patients also felt that they were not always welcome at the doctor's office, and in addition, check-up appointments for chronic conditions such as diabetes and asthma were often postponed. These changes were perceived negatively. "The general practitioner is the gatekeeper of the Dutch health care system. From the GP, patients are referred to the hospital, for example," said Maarten Homburg, "In addition, postponing routine care brings risks, when chronic conditions, for example, are not well controlled. It is therefore of great importance that GP care remains accessible and that care for other conditions can continue even at times of great pressure on the healthcare system."

Non-COVID-19 care also continues

Previous research showed that after the COVID-19 pandemic outbreak, the number of visits to the family physician decreased rapidly. This decline was seen for both acute and long-term care problems. This suggests that many patients stayed away from the family doctor with complaints that they would otherwise go to the family doctor for. There are several reasons why patients stayed away, such as fear of infection with COVID-19 or wanting to relieve the healthcare system. Nevertheless, it is important that patients do contact the family physician if they feel it is necessary.

About the researchers

This study took place in collaboration with the Nivel, Radboud UMC and Maastricht UMC. This study is part of a large-scale investigation into the impact of the COVID-19 pandemic on general practitioner care in the Netherlands.

Patient experiences during the COVID-19 pandemic: a qualitative study in Dutch primary care | BJGP Open