Rex Patrick says locum ‘extortion model’ fueling country doctor crisis
Opulent incentives and perks to lure doctors into critical shortages will not work because fill-in GPs have better ways to cash-in, an SA Senator says.
SA News
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Doctors are being offered lucrative incentives totalling up to $70,000 to move to rural South Australia, but there are still dozens of vacancies.
Among the lures are retention fees of up to $50,000, relocation expenses of up to $10,000, another $4000 for two weeks of orientation and up to $4500 for Covid quarantine if needed.
Education grants of up to $67,000 to supervisors who take them on, generous education grants to the doctors themselves, locum assistance of up to $50,000, help with credentials, study, registration and visas are also being given.
In the past three years the $50,000 retention grants have been made to doctors who took up positions at Streaky Bay, Ceduna, Pinnaroo, Robe, Cummins, Keith, Yorketown and Booleroo.
Private recruitment firms are being paid up to $25,000 to successfully find such doctors. However last week there were 33 jobs being advertised with enticing headlines such as “Sun, sand and surf in iconic rural city” for a GP obstetrician at Port Lincoln.
South Australian Independent Senator Rex Patrick sought the information from Rural Doctors Workforce Agency (RDWA) and gave evidence to a Senate inquiry into the rural health workforce.
The RDWA, which provides the incentives, is the not-for-profit workforce agency for rural SA, recruiting 35 GPs in 2019-20, 39 in 2020-21 and 23 so far this financial year, retaining workforce levels around the 520 GP mark helped by federal and state-funded programs.
Senator Patrick called for measures including removing the current caps on doctor trainee numbers and fast tracking approvals for overseas-trained doctors provided they move to regional areas.
“Every South Australian, whether they live in Adelaide or Coober Pedy, has a right to timely access to a GP,” Senator Patrick said.
“The first thing the government should do is break the locum extortion model. Locums are getting paid $2000 per day to visit remote areas; $10,000 per week.
“In five weeks a locum can make the entire $50,000 retention payment that a doctor who moves to the area is offered.
“It’s a false economy to skimp on the rural doctor workforce attraction scheme while the locum budget blows out. It’s problematic for continuity of care for patients who see a new locum each week rather than a doctor who knows their medical history.”
He also called for more administrative and training support, better Medicare rebates and support from either a second doctor, nurse, paramedic or trainees to avoid burnout.
RDWA chief executive Lyn Poole noted that “no doctor can be directed to work in a specific location under current policies” and that market forces and lifestyles including community support are key factors.
She also said a new generation of doctors were passionate about improving health in local communities “but not 24 hours, seven days a week”.
“GPs want a life outside of their vocation,” she said.
Ms Poole stressed that new doctors and the practices that took them on shouldered all the financial risks, as they were not on a government salary.
“The full forces of the market are at play,” she said. “The key issue impacting general practice in Australia is the need to become profitable through economies of scale – this is a very challenging threat to rural small business general practice.”
In January the former state government entered an agreement with rural GPs, investing an estimated $188m over two years to help attract GPs to regional South Australia.
The state’s Rural Medical Workforce Plan is expanding rural medical training positions and tripling full-time rural medical intern positions, providing 50 rural rotation opportunities for metropolitan-based interns and offering 17 advanced skill registrar positions.
‘It’s the best job in the world’
Rural GP anaesthetist Dr Geordie Beath, 33, loves his work with a passion and strongly recommends young doctors do a rural placement to get a taste of country life.
His role at Clare Medical Centre since 2019 is varied, from clinic work to being on call for hospital emergencies for 48 to72 hours a week.
There’s also anaesthesia work, aged care home visits, emergency retrievals with MedSTAR, research and teaching, in a patch taking in Snowtown and Jamestown.
“This is the best job in the world. I get so much satisfaction out of what we do and can’t imagine anything other aspect of medicine would be as rewarding – what we get to go out here is amazing,” he said.
“I get to do pretty much anything I am interested in. Emergency work is an area of particular interest.”
Dr Beath grew up at Willunga, the son of a veterinarian and a nurse, and says the local GP, Dr Michael Reid, was a role model who was heavily involved in the local community.
He met wife Brooke, a dentist, at Adelaide University while playing volleyball – she had grown up in remote WA and NT before high school at Victor Harbor.
He worked as a junior doctor at Flinders Medical Centre and had placements at Port Augusta, Wallaroo, Kadina and Murray Bridge.
After training in anaesthesia at Lyell McEwin Hospital, he was keen for a career in the country but the couple wanted career opportunities for Brooke and good schools for children Leah, now 6 and Alice, 3.
“Clare was high on the list and fortunately for me they were keen,” Dr Beath said.
He stressed rural doctors need a work-life balance. He has most weekends off though is on call for emergencies about one weekend in five.
“We are lucky here in Clare but there are so many towns short of GPs and the ones who are there get slammed,” he said.
Dr Beath noted better recognition of the role of fully-qualified rural generalists as specialists would also help as young doctors weigh up career options.
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