By Nola Maxfield
HAVE you tried to see your GP recently? If you have, you’ll know it can now take weeks to get an appointment in Bass Coast. If you can't or prefer not to pay, then maybe longer. What happened to seeing someone who knew you and your medical history?
We pay our taxes, like our city cousins, but we get a lower per capita expenditure of the Medicare dollar and poorer health outcomes. Underfunding of the General Practice sector, especially in rural areas, has happened under successive governments. Some initiatives to increase the number of rural students studying medicine and to expose city origin students to rural life have helped, but are only a drop in the ocean.
HAVE you tried to see your GP recently? If you have, you’ll know it can now take weeks to get an appointment in Bass Coast. If you can't or prefer not to pay, then maybe longer. What happened to seeing someone who knew you and your medical history?
We pay our taxes, like our city cousins, but we get a lower per capita expenditure of the Medicare dollar and poorer health outcomes. Underfunding of the General Practice sector, especially in rural areas, has happened under successive governments. Some initiatives to increase the number of rural students studying medicine and to expose city origin students to rural life have helped, but are only a drop in the ocean.
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Why can't you get to see a GP? The causes and the solutions are complex, and unfortunately there is no single magic bullet. In Australia we train a good number of medical students, but go outside the major cities and doctors are thin on the ground. Forty years ago, about 50 per cent of young doctors chose to specialise in General Practice. Today it is less than 20 per cent. Half of those training places are in rural areas, but the rural training pathway is under-subscribed across the nation.
Many medical graduates have no experience of rural life, their partner has a job which can't be done in a rural area, their friends are in the city, or they believe their children will get a better education in the city. General Practice is now perceived as among the poor cousins of the various medical specialties. Far more exciting to be amongst the drama of the machines and time-critical medicine of the emergency department, treating a heart attack patient, than the long, difficult slog of trying to control the risk factors and change people's behaviour to control blood pressure, improve diet and exercise and stop smoking. Government has attempted to deal with the issue by recruiting doctors from other countries, requiring them to work in areas where there is a workforce shortage. However, recent changes to how the government classifies these areas means that doctors who once had to come out to places like Grantville and Wonthaggi (hardly the ends of the earth!), can now work in outer metropolitan areas. |
How long?!
South Gippsland Family Medicine in Wonthaggi used to have six or seven GPs. Now they’re down to one and a half. On August 17, their online booking system listed the next available appointment as September 6 with one GP and September 18 with the other part-time GP. Wonthaggi Medical Group listed their next available appointment in Wonthaggi as Thursday August 22 but several doctors were unavailable until late August or early September. At their Inverloch clinic the next appointment was in six days, but most of the doctors are not available until late August or September. The Group closed its Grantville clinic last year due to the GP shortage. Bass Coast Health CEO Jan Child said the difficulty in getting GP appointments is affecting other parts of the health system, with more calls to ambulances and more presentations to hospitals. “GPs are a critical part of the health system and their workforce shortfalls, like ours, are well understood. She said work was happening federally and locally to address the shortfall in GPs. |
The bulk-billing incentive paid to doctors for treating children and healthcare card holders was recently increased. The more rural, the more you get, certainly a good move. However, no classification system is perfect and towns only 15km apart can have different ratings, so doctors working in Inverloch, Cowes, Newhaven and Grantville get more than those working in Wonthaggi.
Indexation of the Medicare Rebate has either been frozen or inadequate, to the extent that it is now almost impossible to run a quality General Practice on bulk billing. It is also very difficult to recruit doctors to work in bulk-billing clinics when they can earn more, and not have to churn patients through at such a rapid rate, in privately billing clinics.
With the lack of easy access to GPs, people are increasing their use of ambulances and hospital emergency departments are the alternative, seeing sicker patients. All this costs more in the long run.
What can you do? Lobby your politicians.
And reach out to medical students and young doctors who are training in your area and involve them in your activities. Show them that living and working in the country can be fantastic.
Dr Nola Maxfield is a long-time Wonthaggi GP and a former president of the Rural Doctors Association of Australia.
Indexation of the Medicare Rebate has either been frozen or inadequate, to the extent that it is now almost impossible to run a quality General Practice on bulk billing. It is also very difficult to recruit doctors to work in bulk-billing clinics when they can earn more, and not have to churn patients through at such a rapid rate, in privately billing clinics.
With the lack of easy access to GPs, people are increasing their use of ambulances and hospital emergency departments are the alternative, seeing sicker patients. All this costs more in the long run.
What can you do? Lobby your politicians.
And reach out to medical students and young doctors who are training in your area and involve them in your activities. Show them that living and working in the country can be fantastic.
Dr Nola Maxfield is a long-time Wonthaggi GP and a former president of the Rural Doctors Association of Australia.