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Good medicine for the bush (Ballarat Courier, opinion editorial)
12 February 2010. By Dr Harry Hemley.
Gaining timely access to a GP when you are sick has been problem for the Ballarat and district community for more than a decade and new data suggests it could get a lot worse.
In a recent survey, more than one third of country GPs told AMA Victoria they planned to leave rural practice within five years.
We knew we would lose a substantial number of doctors to retirement over the next few years, but the survey reveals that many more doctors are ready to abandon rural practise because they are burnt out. These findings were consistent across specialists and general practitioners.
Rural GPs are overwhelmed by pressures beyond running their own general practice clinics. They’re seeing patients in the local hospital, being woken up in the night to answer phone calls, and accepting on-call arrangements that prevent them from taking holidays or even spending time with their families.
The Brumby Government has rejected calls over the last few years to invest in rural Victoria and fund a medical workforce rescue plan. We hope that the upcoming election may turn the Premier’s mind towards the future health needs of country Victoria.
The disparity between rural and metropolitan services continues to grow because there aren’t enough doctors in country Victoria. If people can’t see a GP, chronic conditions go unmanaged, preventative screenings are overlooked and health concerns aren’t flagged before they become serious.
Inadequate access to health care in the country contributes to poorer health outcomes and as a result, those living in rural and regional areas are likely to live shorter lives and face more illness than their city counterparts.
We know that having a regular GP who you trust and feel comfortable with is one of the best things for your health. Unfortunately this isn’t an option for some in Ballarat and nearby towns.
Victorian GPs and specialists continue to favour metropolitan areas. Despite the great attractions of country practice — more connection with the community, a more interesting case load — younger doctors in particular are nervous about the relentless hours and the lack of support. The prospect of being on call for weeks on end and being woken up in the middle of the night is a downside they would rather avoid.
In 2013, Victoria will have an influx of medical graduates ready to enter the health system. These new doctors will have several years of training ahead of them before they become general practitioners and specialists.
We need older, experienced doctors to remain in the rural health workforce to train and mentor these new doctors. These future graduates could form the backbone of rural hospitals in decades to come, so ensuring they get a good taste of rural life early on is vital. If our survey results come to pass and 37 per cent of country doctors are gone within five years, there will not be enough people left to train the next generation of country doctors.
AMA Victoria has put a $94.6 million, four year proposal to the Victorian Government to assist rural Victoria in retaining its local doctors and attracting more medical practitioners to areas in need. It aims to reduce some of the barriers that prevent doctors from working or staying in rural and regional areas.
The rescue package recommends incentives for doctors to relocate to rural areas and proposes rewards for rural doctors’ long-term contribution to their communities. It also recommends payments for after-hours or overnight phone consultations — services which are not currently remunerated.
The Victorian Government needs to acknowledge what a great job our rural and regional doctors do in caring for local communities, and ensure they have sustainable workloads, and are well-supported. The profession can’t do it alone.
Dr Harry Hemley is president of the Australian Medical Association Victoria
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