GPs also remain on the frontlines of a disaster well after the event itself has taken place.
‘After a disaster is when GPs come to the fore, when the community is still recovering but everyone else has left,’ Dr Burns said.
Many disasters have a long tail, she said, with mental distress and illness, post-traumatic stress disorder (PTSD) and chronic diseases often trailing on for years after a major event.
‘Drought is a particularly difficult one, with that long mental health tail. GPs have a key role as a local, trusted health provider. When you’re in distress, people want to see a trusted face,’ Dr Burns said.
‘GPs are in a key position to identify who does need more help, from anxiety and depression to traumatic bereavement or PTSD, to increased substance use or domestic violence.’
This does not mean, however, that GPs do not still have a crucial role in the early days as well, Dr Burns said, particularly in response to exacerbations of patients’ chronic conditions.
In the case of the 2013 bushfires in the Blue Mountains west of Sydney and the 2010–11 Brisbane floods, Dr Burns said many GPs responded immediately.
‘One GP was seeing patients in a church. He organised a small group of GPs who were then managing patients,’ she said.
‘In the first few days, there’s a lot of care needed around managing chronic conditions. Those with chronic conditions need their medications and may have an increased risk of exacerbations or deterioration, so they need monitoring. This is especially true for those with hypertension and diabetes.’
Dr Burns believes all GPs could benefit from doing a quick planning session to identify the disasters most likely to hit their communities, and map out how they might best respond.
‘At times of such high stress, you don’t usually problem-solve as well. So one of the ways we can help is to plan and to prepare,’ she said. ‘That’s why sitting down and going through the process helps.
‘Here I am, surrounded by bush, so the most likely [disaster] is a fire. Now, say it’s 9.00 am with patients in the waiting room and I get the message a fire is coming and we need to evacuate. What would I do?
‘You just need to do this once – who you’d call, where you’d go, what would you do.’