GP exodus threatens SA rural communities: doctors

DOCTORS NEEDED: Dr Philip Cohen and practice manager Tanya Biddell from the Kangaroo Island Medical Clinic, which urgently needs more doctors. Photo: Stan Gorton
DOCTORS NEEDED: Dr Philip Cohen and practice manager Tanya Biddell from the Kangaroo Island Medical Clinic, which urgently needs more doctors. Photo: Stan Gorton

South Australian rural GPs last night held a crisis meeting to decide how best to protect the future of rural hospital services.

Rural Doctors Association of South Australia president, Dr Peter Rischbieth of Murray Bridge said it was the largest gathering of rural doctors in the history of South Australia, which indicated the magnitude of the problem.

Doctors allege SA Health has refused to consider their proposal for contract reform.

ACM has contacted the SA health minister for comment.

The Australian Medical Association South Australia and the RDASA held an online mass meeting of rural members last night, Wednesday, July 21.

"GPs who also provide care at their hospitals (GP visiting medical officers (VMOs)) - whether it be for inpatient care, emergency, anaesthetics, obstetrics, or surgery - have been offered a renewal of employment contracts that are less favourable than just about any other medical role in the state," Dr Rischbieth said.

"The number of GP VMOs has shrunk dramatically over the past 12 years.

"The continuation of existing arrangements will simply contribute further to the decline of rural health services across South Australia.

"We urgently need a package that fairly values the work rural doctors do in hospitals and to provide emergency and procedural services for our rural communities, and which is attractive to the next generation of rural doctors."

AMA(SA) and RDASA spent months negotiating new contract conditions, and in March recommended to RSS a joint package of reforms that would:

  • reduce costly bureaucracy by moving from a complex fee-for-service model to a basic hourly rate
  • provide pathways to increase GP involvement in decisions about hospital patient care
  • support GPs in the training they provide for medical students, interns and GP trainees
  • the skills and contribution GPs provide.

SA Health responded in July 2021 with an offer that was essentially the same as the current employment arrangements, outraging rural doctors across the state.

Doctors who attended last night's meeting unanimously urged AMA(SA) and RDASA to go back to SA Health's Rural Support Service (RSS) and seek a commitment to accept their reform package.

AMA (SA) vice president, Dr John Williams of Port Lincoln, said that the number of doctors who attended, and their level of concern for the future of rural health care, clearly showed that a crisis point had been reached.

"The AMA SA and RDASA proposal was designed in consultation with rural doctors to attract and retain GPs and trainee doctors in their communities," Dr Williams said.

The offer also reflected doctors' commitment to being able to care for their local patients outside their practices, rather than have fly-in, fly-out locums staff the hospitals," Dr Williams said.

"Rural GP training has been undersubscribed for more than five years, which shows us that young doctors are voting with their feet and are not interested in a medical career in rural South Australia.

"Our offered reforms would help stop GPs leaving and attract a new generation of GP Registrars to train and stay.

"Rural residents who are worried about the future of health services in their region should contact their local Member of Parliament and outline their concerns and experiences."

KI doctor concern

Doctors at the Kangaroo Island Medical Clinic have joined this call, frustrated that they have been unable to attract new doctors to replace the doctors who were leaving or retiring.

Australian Medical Association of SA and the Rural Doctors Association of SA over several months have called for a comprehensive, long-term agreement for rural GPs. They say the rural health situation is reaching crisis point.

The three current associate doctors of the KI Medical Clinic took the extraordinary step of publishing a half page letter in The Islander newspaper last week calling for action.

"It has become clear that the medical workforce across rural and remote Australia is in crisis, and Kangaroo Island is no different; the situation here is only part of a wider problem," reads the letter signed by Dr Johannes Steyn, Dr Jeremy Wells and Dr Philip Cohen.

"It is becoming harder and harder to recruit doctors to rural areas like ours and we must be realistic: it is only going to get harder.

"KI has managed to maintain its medical workforce through a combination of the calling and dedication of a number of long-term doctors on KI as well as good luck: for many years, one doctor has happened to arrive just as one is leaving. But our good luck is running out.

"Despite our very best efforts, it has become increasingly difficult to recruit long-term associate doctors, especially those with procedural skills, namely, anaesthesia and obstetrics."

This story GP exodus threatens SA rural communities: doctors first appeared on The Islander.


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