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A retired Whyalla surgeon says a doctor shortage on the Eyre Peninsula is putting lives at risk.
Key points:
- A retired surgeon says a drain in expertise in regional areas is putting lives at risk
- 18 per cent of medical graduates are choosing to be GPs and even fewer to work in regional towns
- The Rural Doctors Association has welcomed a review of programs and incentives for health outcomes
The Rural Doctors Association of South Australia says just 18 per of all medical graduates are becoming general practitioners with even fewer practising in rural areas, compared with 50 per cent three decades ago.
Former surgeon Michael Damp, who was recruited from South Africa in 2000 and retired in 2014, said the regions had been stripped of the type of work that gave job satisfaction.
Mr Damp said litigation and insurance risks had led to patients being unnecessarily referred to city hospitals.
He said he had watched Eyre Peninsula's medical services dwindle and throwing money at attracting doctors to rural areas was not going to solve the shortage.
Lives at risk
"Rural medicine is dying, the competency of rural nursing is going down because they're not exposed to things because everything gets referred out of the rural areas," Mr Damp said.
He said Royal Flying Doctor Service retrievals were a "cure and a curse" because the fleet had grown so much it was easier to get a retrieval than tend to the patient in a country hospital.
But he said it added three to four hours before the patient was treated.
"Because people don't manage problems on a regular basis they'll refer you and if the referral team [from Adelaide] doesn't get you in time, you'll die and that's just the honest truth," Mr Damp said.
He said even simple procedures such as setting broken bones were referred to Adelaide, citing two cases from Port Lincoln and Whyalla where patients waited three days for fractures to be treated because they weren't an emergency.
"The dislocation to patients and their families is horrendous," Mr Damp said.
He said there were two GPs in Cowell, one each in Cleve, Elliston, Streaky Bay and Kimba, three in Tumby Bay, up to 17 in Port Lincoln and about 12 in Ceduna when he arrived in the region in 2000.
He said many of them offered minor surgeries that no longer took take place in even the larger regional centres.
"Now that institutional memory is gone," Mr Damp said.
"The competence of the nursing staff and theatres has gone."
He said money incentives would not solve the fact GPs didn't want to go to regional centres because they couldn't use all their skills.
But others think Medicare incentives could work.
Bucketload of money
Brian Symon, who worked in country areas before moving to Adelaide, ran a company that recruited 350 overseas GPs to Australian regional areas over 12 years.
He said the federal government needed to urgently prioritise doctor recruitment.
"The Commonwealth has to make a decision about whether it wants an adequate workforce or not," Dr Symon said.
He said the number of medical students should be increased and Medicare schedule fee should have a very strong pay differential so country towns became attractive.
"What I would recommend if you work in Port Pirie, the scheduled fee be 125 per cent, if you work in Kimba it's 220 per cent and if you're going to work in Andamooka it's 300 per cent," Dr Symon said.
"At the moment they're digging iron ore out of the ground in the Pilbara, and they pay a bucket load of money and that's the way you attract workers."
Rural Doctors Association of South Australia president Peter Rischbieth said the issue was more complex than monetary solutions and included career choices and workload factors.
"Back when I started, when I came to Murray Bridge 36 years ago, 50 per cent of doctors who graduated from medical school would go into general practice," Dr Rischbieth said.
"Now we're down to 18 per cent … and obviously a small number of them are going to be country GPs."
He said doctors had in the past coped with huge workloads that were not healthy for them or their families.
He said replacing those doctors took the equivalent of 1.5 doctors under improved work conditions.
Single employer model
"The attraction for doctors to go to the one or two-doctor towns has still been decreasing because people feel they're working in isolation so the smaller towns with the one or two doctors have been harder and harder to fill those vacancies," Dr Rischbeith said.
He said a single employer model with varied placements, locum support and video conferencing aimed to boost country GP numbers.
He said the many federal government programs and incentives to address the shortage were being reviewed.
"What is the best bang for your buck from federal and state incentives to encourage people to go rurally," Dr Rischbieth said.
"A lot of money has been put into this but not all of it has been successful."
Federal Health Minister Mark Butler said there were bulk billing incentives for rural and remote locations and the Workforce Incentive Program provided financial incentives of up to $60,000 a year for doctors working in the regions.
He said the 2023/2024 budget allocated $163 million to attract and retain more health workers to rural and regional Australia through improving training and incentive programs.
"There is no higher priority in health for the Albanese Government that rebuilding general practice," Mr Butler said.