Experiences of primary healthcare professionals and patients from an area of urban disadvantage: a qualitative study.

' We are seeing a lot of newly arrived migrants and refugees and recently we start to see a lot of refugees lately . ' (AHP01)

' [We] do get a fair amount of mental health, anxiety, depression in the teenagers … In the middle age sort of category, again a lot of anxiety, a lot of stress-related depression . ' (GP06)

' Chronic disease is pretty much prevalent in this area … Western Sydney is a hot spot for diabetes … ' (GP01)

' … because of the poor education … they don’t have the understanding to look after themselves. ' (GPR05)

' … [patients] can afford to spend money on the cigarettes but … have no money to spend on medications. ' (GP12).

' When they know about their medicines they are going to be empowered to … grab hold of their own situation. I find that when they don’t know what they’re taking things for … they’re lost … just taking things but they’re not taking responsibility for their own health . ' (AHP04)

' … People come in with mental health issues and I don't know if you can do that in six minutes … I educate my patients about why they can't have antibiotics for a cold, I take the time to do that . ' (GP06)

' … if he thinks there’s really something wrong, he’ll do everything to find out what it is … if you’re really sick, he will go out of his way to try and fix you up … I like that. ' (Pt04)

' So they … adopt you into their lives and you become part of their lives … and they think of you as a sister or a daughter, or a surrogate mother . ' (GP04)

' You kind of have to relate to them really and explain to them why from a medical perspective X, Y, Z is indicated or not indicated, and ask why they believe what they believe, and then if they tell you, then you can discuss it. But if they don’t feel that they can relate to you … then the trust and therapeutic relationship is not working. ' (GP15)

' I have a lot of professional satisfaction from working here. So I love my job and I love the staff and I love my patients .' (GP08)

' I just I enjoy the fact that the things that we’re implementing actually make a change and this person manages their health, they don’t end up going to hospital every other week . ' (PN03).

' … I prefer not to [work] in affluent areas … there are obviously illnesses everywhere, but I do feel a bit more useful in the area that’s less affluent. ' (GP14)

' It’s exhausting and it’s one of those jobs that you’re working pretty much from the minute you get out of bed until the minute you go back to bed … ' (Rct02)

' We don’t have enough time to give to the patient to really go deeply into the problems … putting band aids on it, which I don’t like. ' (GP11)

' Mental health — it does eat into your time a lot. They'll come in with a 15 minute appointment … 20 minutes later you've already eaten up 35 minutes and it makes you late. That does increase my stress. ' (GP06)

' … you'd like to think that there's a specialist who can help you take care of the patient … but if this patient won't go in to see them … it keeps you awake at night. ' (GPR04)

' … patients just don’t realise that he’s only one doctor and there’s just not enough time … ' (Rct05)

' I think it takes its toll … medicine has one of the highest divorce rates and one of the highest suicide rates out of the professions … often it ends up in situations where there’s … burnout … people just can’t … cope with that. ' (GP09)

' … I've seen so many [doctors] which makes it hard because then they say, " Have you had this vaccination? " And I think, "I can't remember and it's probably not on your record" . ' (Pt02)

' … I do the dressing, they’re not sitting out there waiting half an hour for the doctor . ' (PN03)

' I like being part of the team. It’s better than working in isolation. ' (AHP04)

' … you need the right support staff … I'm not a dietician, I'm not a psychologist, I'm not a physio … I'll use some of those elements of those in my normal day-to-day routine … ' (GP10)

' When you’re sick, virtually you have to close the practice, because you can’t have somebody else come in … ' (GP09)

' We are really lucky to have Mt Druitt Association … that relationship with other doctors and we can talk about things. ' (GP14)

' … governments don’t appreciate general practice … governments just say, " … we’ll just turn the screws a little bit, [GPs] won’t mind " . ' (GP09)

' I see patients around every 10 minutes or 15 minutes … process information … put a plan and I need to make … sometimes two or three decisions in the same consultation … all your decisions has medical and legal consequences … for your consultation you’re going to get $35 [AUD] and you pay at least 40% overheads … leave you with around $20. Then you pay tax … that’s $10. So you study 13 years, you make a lot of decisions … for ten bucks. Not fair I think . ' (GP08)

' Trying to get blood test results from the hospital was a time-consuming and quite honestly frustrating process … So there’s the hospital’s existence, silos, whereas we are trying to do the opposite . ' (GP05)

' It is not good enough for individual patients to have isolated experiences of excellent care. They actually need care which is stitched up . ' (GP07)

' … they’re in crisis I find it’s very, very difficult to get them engaged with the services … contact an access team or a mental health crisis team. They’ve got all of these different red tapes and criteria … ' (PN07)

' … had to wait a month just to do the consultation with the specialist, a few months more for the surgery … through the public hospital system . ' (Pt07)

' … can’t afford medication, they have no transport, they have no money for fuel even when they have a car or it’s not registered or when I refer them to see a specialist or to other health professionals they can’t afford to pay .' (GP12)

' … the health system, it’s pretty complex for me to do and I’ve been working for New South Wales Health for 18 years … So for someone who is not well educated who has lots of pressures, they haven’t got a chance really to find out what help there is for them. ' (PN03)

' … doctors are often quite willing to donate a bit of time but especially when we’re talking about … [AHPs], their hourly rate is not actually that high so it is quite a big ask to ask them to donate more time . ' (GP05)

' … you have the Federal who looking after Medicare and you have State who looking after hospital … a lot of improvement needs to be done. ' (GP08)

' … where I'm concerned is health should be funded by one body. ' (GP13)

' They're [PHN] just so supportive … having that number to ring and say, " I don't know " … And they were the ones that sort of got me on to a few different programs … got me orientated . ' (PN01)

' … put this research … in front of the media … doctors are very busy, they don’t talk. And other people are talking a lot, very loud … we cannot do it . ' (GP11)