A General Practitioner who retired from clinical practice to live in Yamba and took five months to secure an appointment with a local doctor whose books were open, says a large percentage of GPs don’t have their own doctor.

After living and working in Far North Queensland for more than two decades, Dr M said she and her husband bought a motorhome, with plans to travel Australia and escape the tropical heat while she worked as a locum.

“I’ve worked in rural and remote medicine for the whole of my career, first in South Africa, and then we came to Australia in 2001,” she said.

“I first worked on The Yorke Peninsula in South Australia for two years and then we moved to Cairns in 2003 where I worked for the RFDS.

“Our outreach clinics were in the remote communities of Cape York.

“We moved further north to Cooktown for nine years and then back to Cairns, but it was just getting too hot to enjoy living there.”

After leaving Cairns in January 2022, Dr M said her first locum position was at Maclean Hospital where she spent 10 days, before they became trapped in Yamba by the flood.

After previously visiting Yamba in the early 2000s, Dr M said they bought a house in Yamba.

Initially working for 3 days a week in Grafton Hospital Emergency Department, she then worked closer to home for two days a week for the outreach clinic at Maclean run by Bulgarr Ngaru Medical Aboriginal Corporation, before she retired from clinical medicine in October 2023, and began working for the Remote Vocational Training Scheme as a medical educator.

“The Remote Vocational Training Scheme trains registrars to work in rural and remote Australia as registered GPs,” she said.

When her search for a local GP began in December 2023, Dr M said she enquired at the three practices on Treelands Drive, Yamba, but their books were closed, and they said to try again in January.

Five months later, when she recently tried again to get an appointment, Dr M said she was fortunate that The Family Practice in Yamba Fair, had recently recruited a new female GP so she was able to get an appointment.

“I probably wouldn’t have been able to get an appointment unless the Family Practice at Yamba had recruited another doctor,” she said.

Dr M said a 2019 story published by the Royal Australian College of General Practitioners, provided to the CV Independent, stated that only 40 per cent of doctors had their own GP.

She suspects this is higher in regional and rural areas.

“A lot of GPs don’t ever get their own doctor for their own health,” she said.

“They treat themselves and their families, which is not a good thing” she said.

Dr M said there were many reasons why GPs don’t have their own doctor, particularly in smaller regional or rural areas.

“They know that their colleagues are overworked already, and it’s hard to be objective in some ways while treating a colleague,” she said.

“Sometimes as a doctor, it’s hard to be treated as a patient.”

Doctor’s suggested solutions to shortages

Dr M has offered some solutions to the health crisis in the region, which could ease the pressure on local GPs and enable doctors to access consultations with colleagues.

Dr M said when she previously worked in South Australia the rural health workforce agency supported rural and remote doctors and their families by providing a GP who came from out of town.

“They had a program called “Doc to Doc” where a doctor from Adelaide used to go out to regional towns and do sessions for GPs,” she said.

“It was very successful.

“The local GPs didn’t have to see their own colleagues as patients which was often very hard to do for a number of reasons.”

She said a similar model of care for GPs in regional and rural NSW to what was implemented in South Australia would be beneficial.

“I think it would be a fantastic idea and hopefully you would get a lot more GPs seeing doctors for their own health,” she said.

She said GPs could see the current health crisis coming 20 years ago.

“Every time there is a cut in health care services it gets cut at the primary care level, and if you haven’t got good primary care, people end up in hospital Emergency Departments,” she said.

“That’s why you’ve got (Ambulance) ramping, that’s why you’ve got people sitting for eight hours or more in Emergency Departments…we could all see it coming.”

Dr M offered a sensible solution to ease the burden on Clarence Valley GPs, while catering for the ever-increasing population in local over 50s communities.

“I think we need to look at some different innovative models of care.” she said.

“Some of the over 50s communities that are owned by private businesses are providing a contracted GP for their residents, and some of the villages have their own clinic room and a GP, which eases the burden on GPs in the area.”

Another model is for a GP to set up their own business as a home visiting service for residents in over 50s communities. 

“The beauty of that is you don’t pay for any additional staff, you don’t have to pay for a premises, and with all the over 50s developments being built here, you’d never be short of work,” she said.

She said she was surprised that GPs aren’t more attracted to living and working in Yamba because it’s such a wonderful lifestyle, but the Medicare rebate and cost of running a business makes establishing a practice expensive.

“General Practice in Australia is a business model of care, and they have to keep afloat,” she said.

“I think being a General Practitioner in a rural or remote area, is one of the hardest jobs you can do in medicine.

“When I came to Australia in 2001 the Medicare rebate for a standard consultation, which is anywhere between 5 and 20 minutes, was $28.75, now the Medicare rebate is $41.” 

She said most people think GPs make a lot of money, but what they don’t understand is the overheads involved with running a General Practice.

“If you consider the cost of the overheads such as paying the staff, including nurses, administrative staff, cleaners etc, add on paying for equipment and disposables such as dressings and so on, and then paying rent and rates for the premises, the overheads are so high that you hardly have any bulk billing practices anymore that can survive financially,” she said.

Dr M said GPs are becoming frustrated with the level of care they can provide while remaining financially viable with the current Medicare rebates.

“If the practice is to survive as a bulk billing practice the GPs would have to see a patient every five to ten minutes, which means the doctor can’t spend the time needed to provide really good medical care,” she said.

“That’s why doctors are leaving.

“The number of final year medical students whose first-choice career option is general practice has fallen to 13.1 per cent, according to a large-scale survey carried out in 2022.”

This article appeared in the Clarence Valley Independent, 17 April 2024.