List of rural Tasmanian towns crying out for doctors lengthens

A quick search of GP job advertisements has revealed vacancies at Launceston, Deloraine, George Town, Scottsdale, St Marys and St Helens, Burnie, Somerset, Devonport, East Devonport, Ulverstone, Wynyard, Sheffield, Port Sorell, Smithton, Rosebery, Queenstown, Strahan and King Island.

Insiders say up to 150 vacant GP positions remain unfilled.

The East Devonport community are concerned its medical centre might close.

The search for a Campbell Town GP also continues, but how can a region successfully find a local doctor when many regions and small medical centres are also on the hunt?

In a 1998 Medical Journal of Australia article, looking at the career progression of 262 University of Tasmania medicine graduates from the 1970s and 1980s, just 17% were working in rural or remote locations and just a small minority remained working in Tasmania.

In Rural Remote Health from 2017, an article looking at University of Tasmania international medicine students, found just 42 of the 261 IMS graduates from 2000 to 2015 were working in Tasmania.

It wrote that these University of Tasmania graduates "make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context".

More recently, of the 125 medicine university students graduating every year in Tasmania, up to 50 per cent are international students, and many of these are known to leave the state.

Royal Australian College of General Practitioners state deputy chairman Dr Toby Gardner said retention in the state of early career medical graduates was difficult but another hurdle was making general practice an attractive career choice.

Dr Gardner said the prestige of general practice had dropped, where it is now almost looked down upon compared to 40 years ago.

But he said a major factor was financial incentive.

"Nationally we are down in GP numbers, we are not filling our training places in general practice where we always used to have a surplus, so we are trying to encourage more people to see it as a career," Dr Gardner said.

"It has been less attractive for junior doctors to move into general practice when they see the strains and stresses. We are working longer hours to make less money...and the income gap has widened between specialists and GPs," he said.

"So junior doctors' decisions are dictated by finances and how they want to set up their life."

Dr Gardner added that Tasmania used to be a more affordable place to live when compared to the major cities but house prices and other costs have gone up, and so the incentive for doctors to move here has been lost.

This same issue in Tasmania's rural and remote areas is compounded by isolation and distance, where spouses might work in cities, and kids' schooling becomes an issue.

Australian Medical Association president John Saul said multiple factors had caused the GP shortage, but spearheading that was a shrinking medicare rebate which made it difficult for doctors to keep up with costs.

He said it was a long-standing issue brought about by a lack of Commonwealth funding focus on general practice, but this was recently, and finally, addressed in the recent Federal budget.

"We have seen the writing on the wall for the last twenty years that this shortage was going to happen and we have been making as much noise as we possibly can," Dr Saul said.

"When I've worked in rural areas where there is an under-supply of doctors, patients come in less frequently with more health problems...people often turn up with six to eight problems, and every consultation is long, involved and challenging," he said.

"So it is difficult medicine that is made even worse by GP shortages where there are not enough doctors to share the load."

Moves are afoot to improve the attraction and retention of GPs in Tasmania for the medium to long term.

Dr Saul said the single employer model brought in by the state government was a welcome policy, where doctors training to specialise in rural medicine can choose to be employed by the Tasmanian Health Service.

This will mean they will retain any employment benefits as they progress in their training placements, and be entitled to annual leave, sick leave and other benefits when working in a hospital setting.

A recent pay deal offered by the state government, where hospital doctors will receive a pay rise to improve competition with mainland wages, was also viewed as a positive step forward by Dr Saul, who saw an opportunity for flow on benefits to general practice.

"If we can get more doctors in our public system, and attract doctors from the mainland, then there is more chance that it might filter into other training programs, where those doctors might later choose to go into general practice," he said.

Dr Gardner said the RACGP was also lobbying for a return of a pre-vocational general practice training within medical training, which is where students can elect to do a three month stint working with a GP.

"It gave junior doctors exposure to what life as a GP could be like, showing them that rather than working with just coughs and colds, we are dealing with all sorts of medical conditions," he said.

"It also showed that rather than being on call for a hospital, or working long hours at a hospital, they could see that working as a GP might be a better lifestyle choice," he said.

"Basically it is about making sure that we can inspire this generation into general practice."

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