Rural Australia continues to call out for primary health care professionals, a report by the Regional Australia Institute has found.
The report, which highlights findings of the internet vacancy index, published by Jobs and Skills Australia, identifies medical practitioners and nurses as the most in demand job classification for regional Australia.
General practitioners, who are not dealt with separately in the report, remain a major area of concern for public health experts, with a rural shortage preventing many Australians from enjoying the benefits of a fully functioning health care system.
Dr Andrew Bonney, south coast general practitioner and chair of general practice in the medical school of the University of Wollongong, says that GP’s play a vital role.
“It’s the first point of access to the healthcare system,” Dr. Bonney said.
“You need continuity of care to maximise the benefits from accessing the healthcare system… that’s been shown to help outcomes across most chronic diseases, reduce hospitalisation rates, reduce mortality.
Despite the fact that approximately 28 per cent of Australians live in rural and regional areas, only 21.2 per cent of the countries medical professionals ply their trade in these places.
This disparity is compounded by the fact that people in regional areas are more susceptible to poor health outcomes.
“The health of people in rural areas is quite a lot worse than people in urban areas,” Dr. Bonney said.
“You run double the risk of ending up in hospital with a potentially avoidable hospitalisation due to a chronic condition in a rural area”.
Barriers
The lack of general practitioners in rural areas, specifically, raises questions as to the reasons why medical professionals do not seem to be distributed equally across metropolitan and regional areas.
For Dr Bonney, the low number of GPs moving towards these areas is a deterrence in itself.
“If you’re feeling like you’re the only one there, it’s pretty isolating and pretty exhausting, and places you at risk of burnout,” he said.
The places in which medical graduates study and complete practical training have also been shown to have a significant impact on the likelihood that they will go on to work in a rural environment.
The lengthy process of getting a medical degree and the age at which graduates enter the workforce may have a significant impact on this.
“It’s the time of the life where perhaps you’re having children, you’re thinking about buying your first home and once you put those roots down, it’s a very big ask then, to shift people across to a rural area”. Dr Bonney said.
The low rate of medical graduates who opt to specialise in general practice has been reflective of a greater crisis and has been a cause of concern for the Royal Australian College of General Practitioners, who have warned of an impending nation-wide dearth of GPs.
Rates of medical students opting to engage with general practice training have been steadily declining, a trend which has further impact on the availability of practitioners to work in rural areas.
Dr Yann Guisard, director of knowledge mobilisation at the NSW Rural Doctors Network has witnessed this trend unfold.
“The number of graduates of medical schools has increased but the number of graduates who are interested in becoming GPs has dramatically decreased.” He said.
“About ten years ago, about fifty to sixty percent of graduates wanted to become GP’s and of them, a fraction would go rural, and a fraction would go urban, these days, it’s fifteen.”
For Dr Guisard, the role of a rural GP is a unique one, and not necessarily a lifestyle that is sought after any longer.
“Rural GP’s, traditionally, were not just rural GP’s, they were community leaders, they were trusted individuals. They might have leadership roles in the council or in the community somewhere”. He said.
“The reality is that not all young graduates want this. People are changing in terms of the lifestyle they want… they want set times, they want predictable jobs, they want holidays with their families, they value their time with their family”.
A way forward?
Leaders in the medical community continue to propose solutions to the rural GP crisis and the government have allocated money to resolving the issue. Dr Andrew Bonney believes that an increase in the bulk billing rebate in certain areas may incentivise more GPs to make their way to the regions.
“There’s been some very positive moves around changes to Medicare funding in the last budget and particularly, an increase in the bulk billing incentive”. He said.
Noting however, that the change will need to be significant.
“That has been six dollars in metropolitan Australia and nine dollars in rural Australia which, you’d have to say, is not going to change anyone’s mind.”
For Dr Bonney, the importance of the role of GPs in the primary care of rural Australians, may require the government to implement even more creative solutions. He asked;
“Are there ways that general practitioners can be employed by state government as a public good?”
Dr Yann Guisard believes that the benefits of being a general practitioner do not get the coverage they deserve.
“They see their patient for different parts of their lives…they’ve actually, in some cases, they’ve been at the birth of several of their patients over several generations. That means that those people do create a very strong emotional link”. He said.
“We’ve forgotten to market the true value and true role of GPs”.
feature image credit: pexel, 2023.
