Solving Australia’s rural GP shortage

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By Bongkarn Thanyakij (CC BY)

There are over 100 job vacancies in health departments across country Victoria with rural towns struggling to attract doctors.

Recently, the struggle to find doctors to work in Australia’s rural areas has become a well-publicised issue, especially as populations in smaller towns continue to decline. Clinics have gone to great lengths to attract doctors to their area, yet their efforts often lack the appeal for many city-bound medical professionals, such as culturally diverse communities and numerous entertainment options.

According to an Australian Institute of Health survey, just over 20 percent of people living in rural areas said they could not go see a general practitioner (GP) because there weren’t any nearby. And almost 60 percent said they had no access to specialists in their area.

To ensure that those living in Victoria’s rural areas have access to GPs, the long established organisation Rural Workforce Agency of Victoria lists job opportunities in health departments across the state and it currently shows over a hundred vacancies for GPs in regional areas. While attracting GPs is a challenge, maintaining current doctors in rural areas is also proving to be a difficult process.

Dr Shiham Zaveer is a general practitioner at the High Street Medical Centre in Preston, Victoria and formerly worked in the emergency department at Wagga Wagga in New South Wales. He took the opportunity to work in a rural area when he came to Australia from Sri Lanka and says he enjoyed the experience.

“It is very difficult for foreign graduates to come into the country,” Dr Zaveer said.

“Beggars can’t be choosers; I got an opportunity and I took it. The people were very friendly, there was no traffic and I learnt quite a lot. Essentially it was a good experience.”

After two years Dr Zaveer moved out of the rural area and into Melbourne, an environment he says he was more suited to.

“Melbourne was always the place I wanted to come [to],” he said.

“I’ve always been in city environments; I haven’t been much in the country. The country is a nice change of lifestyle, I did like it for a bit. But I couldn’t see myself long-term being in the country.”

Ritchie Dodds, CEO of the West Wimmera Health Service (WWHS), which provides community health facilities for more than 16,000 people in the region, says he tries to make the transition from city to country as easy and as reasonably possible for his doctors.

“We help them with housing, with travel costs, vehicle access and just provide any sort of reasonable support we can,” he said.

“It’s obviously extremely important for small rural communities to have GPs locally accessible for people.”

In November last year the WWHS clinic in Nhill found itself with only one GP available to the community. After changing their medical service to Rural Doctors, the WWHS were able to hire four new GPs from far-flung areas such as Sydney and Brisbane.

“We went from having insufficient, unsatisfactory service to now having what we need,” Dodds said.

“It’s a case of all duck or no dinner, if you haven’t got them [doctors] they can be very hard to get. But once you get them and they’re doing a good job, everything flows from there.”

According to the Australian Bureau of Statistics more than half of doctors working as GPs in 2011 were born overseas. Under the current five year overseas trained doctor scheme, overseas doctor graduates are made to work in rural areas for at least three years before they can move to working where they please. 

Although Dr Zaveer didn’t go through the training scheme, he says that it can be intimidating for overseas doctors that want to come to Australia, especially for those who were brought up in cities with different backgrounds and aren’t familiar with rural environments.

“A small issue I had while I was there [Wagga Wagga] was halal. Not that it was a major issue but when you want to go out there was limited choices. We ended up going to the same places and there wasn’t much else to keep us entertained,” he said.

“If there were a bit more diversity, more cultures available and different things available, doctors with their own backgrounds may feel more fitted in.”

Another factor of the rural doctor shortage is that for medical students, becoming a GP may lack the appeal of other roles in the health department. Dodds says that due to doctors training in specialised fields of medical care, there hasn’t been enough doctors coming through as general practitioners.

“Being a GP I suppose can be a very daunting experience coming through. Sometimes if you come out of the city as a single doctor there may not be the support there for you in your job as there might be in the city,” he said.

“That probably caused a fair bit of reluctance from some people.”

Governments are working hard to improve rural GP numbers in Australia. This year a workforce incentive program was put in place to encourage more GPs to work in rural and remote areas and grow careers in rural medicine. Dr Zaveer believes that doctor vacancies can be filled by easing restrictions on foreign doctors entering the country and offering more incentives.

“I know there’s a lot of foreign doctors that would love to come into Australia but the criteria for selection and getting in is very difficult,” he said.

“These rural clinics can easily be filled by opening up more opportunities for the foreign doctors.”