BUSY BASE: When there are no GPs in smaller towns, larger hospitals like Wagga and Griffith carry the load.

BUSY BASE: When there are no GPs in smaller towns, larger hospitals like Wagga and Griffith carry the load.

It's time to treat the cause of the rural doctor shortage

Comment: It's time to treat the cause of the rural doctor shortage

Health
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A new approach is needed to training and retaining GPs.

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OPINION

When I was a kid, growing up in Junee, we had an absolutely devoted town GP.

John Potts was, for many years, the town's only doctor. He saw patients in his surgery during the day, visited the hospital when he was needed and was on call pretty much constantly at night and on weekends.

He was highly respected by the community, but these days I have to ask myself how he managed to work an enormous number of hours, week after week, year after year. He carried such a huge responsibility.

If you talk to people from other smaller communities, many of them have similar stories about their own versions of Dr Potts: GPs who work long hours and rarely even have the chance for a weekend away.

While the dedication of these amazing doctors should be applauded, we also need to acknowledge that they should never be expected to have to shoulder such heavy workloads.

Being a GP - or more specifically for us, a rural generalist - is a specialty like no other. Rural GPs look after everyone from your newborn to your nanna.

GPs have also traditionally provided medical care in hospitals, where they could be confronted with everything from an unexpected labor and delivery to a serious illness or critical injury from an accident.

This job simply isn't for the faint-hearted, so you can understand why a great many medical students are opting for other specialties, particularly in bigger hospitals with more facilities and easy access to the second opinions and advice of colleagues.

The problem with that is obvious: Not enough new GPs coming into the system to replace those who are ready to retire.

We have had some success in bringing overseas-trained doctors to our regions and expansion of rural medical schools, like those based here in Wagga, is also helping to convince young doctors they should stay in rural practice.

But that's not going to be enough.

This job simply isn't for the faint-hearted, so you can understand why a great many medical students are opting for other specialties.

Here in Wagga, at the UNSW Rural Clinical School, a new training program is being developed that would streamline what is offered to GPs-in-training, who have traditionally found themselves bounced between employers as they move between hospitals run by local health districts and private medical practices.

But, as is often the case, bureaucracy is throwing a spanner in the works. Responsibility for health administration is split between the states and the federal government, which oversees Medicare, and changes would be needed.

It's not good enough for bureaucratic process to be a leaden weight on positive change. "It's how we've always done it" is a rubbish, lazy excuse and it won't cut it.

Later this month, protesters from across the region are planning a rally in Wagga to call for more doctors in regional hospitals.

There are 33 hospitals within the Murrumbidgee Local Health District and 29 of them rely on GPs to act as the on-call doctors at these facilities.

If there are no available GPs, most patients are going to have to bypass smaller hospitals and head to bigger ones like Wagga or Griffith.

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The potential problems are obvious. Patients are facing delays in getting what could be critical care and paramedics are not only facing long hours on the road while they shuttle people around, they could also be out of their home towns when a critical situation arises and someone needs immediate medical attention.

You know how politicians are fond of telling us that "nothing is off the table" when it comes to some controversial subject or other? Well, sorting out the shortage of rural doctors is one of those issues where they should be loading up a whole buffet with suggestions.

We pretty much need to chuck out the old model and start again.

We need to make sure their training is adequate, so young doctors feel confident about setting up a practice in a more isolated area.

If we are expecting them to be visiting medical officers at the local hospital, then we need to make sure this doesn't become a heavy burden. With fewer medical students opting for a career in general practice, we cannot afford to burn out the ones who do take on the challenge.

They also need decent working conditions, with the opportunity for a life beyond their professional responsibilities.

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