Local doctors for small communities Currently Cowell is following the regular path of small communities searching for a permanent doctor. The ‘80s and ‘90s were a difficult period for sourcing country doctors when trained doctors were in surplus and our cities were over-serviced. Medical undergraduate intakes were reduced and the surplus reeled in but the number was restricted for too long leading to national shortages. These were met by overseas trained doctors. It worked well for us by insisting country service be a pre-condition of immigration. In the 10 years to 2013 numbers of regional GPs in SA rose significantly, however most have been overseas recruits and they now form close to 50 per cent of our regional workforce. In response Australia doubled its undergraduate intake and as new doctors surge onto the market we will slash our imports. As we don’t control where our graduates practice it raises an important question: Who will service country areas? We grasp the hesitancy of locally trained doctors to move to the country including professional isolation, lack of confidence, out-of-hours service, employment opportunities for professionally qualified spouses and a lack of educational options for children. However there is a double imperative to act as we head again for over servicing in the cities and shortages in the country. The solution I propose is relatively simple but will be politically challenging: Postcode Specific Medicare Provider Numbers. Vested interests will protest restricting where doctors can set up business but the medical market is closer to a public employee model similar to teachers and nurses than plumbers or lawyers. Teachers only win jobs in schools with vacancies. They can’t set up a public school next to where they live because they prefer to live and work there, they need to take a job where service is required. Not having a Medicare number wouldn’t stop doctors from setting up where they wish but taxpayers have the right to subsidise services where they are needed and not where there is no public interest doing so. This would require a transition period and the grandfathering of current licenses, however the failure to act will lead us down the same path from the ‘80s. I have a discussion paper on this issue available on my website. Source
