TOP STORIES

GP shortage a reality

Australia's rural and outer-suburban areas are suffering a shortage of hundreds of GPs, according to the initial results of an AMA-Access Economics work force study.

The review challenges statistics recently released from the Productivity Commission which showed a 4.3% increase in the number of rural and remote doctors in Australia -statistics, according to AMA Federal President Dr Kerryn Phelps, that fail to recognise the human dimension of the rural doctor shortage.

Talks on Medicare future

AMA President Dr Kerryn Phelps was due to meet Federal Health Minister, Senator Kay Patterson, last week as part of the high level talks to determine the Governments position on the future of MBS.

AMA Executive Council last month discussed MBS issues in view of the appointment of the new Health Minister, and the conclusion of the Relative Value Study (RVS) last year.

ACCC misfires on rural health

The AMA has hit back at a string of missives from competition watchdog chief Allan Fels, which represented the Association's position on the application of competition policy to rural medical practice as dangerous for many country people.

In a second submission to the Federal Government inquiry into the impact of the Trade Practices Act on rural doctors, the ACCC said there was no evidence that the Act hindered recruitment or retention of rural doctors.

Expansion of GP testing role

A task force to oversee the expansion of GP point of care pathology testing (PoCT) will be established following a meeting of government and medical groups in early February.

Participants including the AMA, Royal Australian College of Australian GPs, Royal College of Pathologists Australasia and government representatives agreed to establish a sub-group of the Quality Use of Pathology committee to oversee the expansion of PoCT, due for completion in November 2002.

GP prescribing cuts rejected

The AMA will consider mounting a campaign to protect quality GP prescribing, as the Federal Government signals cuts to the expanding PBS budget.

At a meeting later this week, Federal Council will consider a recommendation from the AMA Council of General Practice to campaign against any bureaucratic and restrictive prescribing regulations.

INSIDE

Hostility may be the final straw

In this edition of AM recently retired Canberra obstetrician and gynaecologist Dr Heather Munro expresses her concerns at the hostility between doctors and the opponents of medical intervention in childbirth.

Waiting to come home

Trainee GP Dr Paul Carroll has spent time working as a medical officer at the Woomera Detention Centre. After an initial reluctance, Dr Carroll decided to speak out in the hope of improving conditions for detainees.

Work life flexibility

The AMA's Work Life Flexibility Project seeks to address changes in the medical work force, junior doctor aspirations and present medical training and workplace arrangements by promoting cultural change in the medical profession.

See inside AM for a copy of the Work Life Flexibility Project liftout.

From the President: Beware misleading statistics

Dr Kerryn Phelps

You would have thought that with all the factual and anecdotal evidence currently available there would be no disputing there is a shortage of GPs in regional and outer-suburban Australia.

The recruitment and retention of doctors in country towns is a problem that has been around for some time, and all the reports from local communities indicate the problem is getting worse, not better.

Following much lobbying by the AMA, the Federal Government has responded in part to this crisis with two major initiatives - a medical indemnity summit (expected in April) and a review of the effects of the Trade Practices Act (TPA) on the recruitment and retention of country doctors.

So it came as some surprise earlier this month when the Productivity Commission claimed that country GP numbers had gone up by 4.3%. Even more surprising was the Greek chorus of support for this 'miracle' turnaround in country doctor numbers, including from senior members of Government.

Well, the feedback from doctors and patients and whole communities is that these statistics are wrong - more doctors are leaving country practice and fewer doctors are replacing them. I find this simple arithmetic more compelling than the Productivity Commission's detailed statistical analysis.

There is no doubt the statistics have been inflated by temporary resident doctors (TRDs), overseas-trained doctors and part-timers. The fact that the GP work force in the Productivity Commission report differs by about 4,000 with the figures in the August 2000 report of the Australian Medical Workforce Advisory Committee (AMWAC) makes me lean further toward the facts and away from the figures.

The GP work force problem is compounded when the Government continues to use questionable statistics to screw down the numbers of Australian medical graduates who can train for general practice by limiting provider numbers and training opportunities.

This all sends a clear message that public policy - especially public health policy - should be based on what the people are saying and not how the statistics can be made to look.

The situation was summarised perfectly by Dr Peter Roberts of Mudgee, NSW, in a letter to the Sydney Morning Herald on 4 February 2002 in response to the Productivity Commission's analysis:

I am pleased to hear that doctors are returning to the bush. However, in our idyllic country town of Mudgee, just 3 hours from Sydney, we can see no evidence of it.

After a combined 50 years of rewarding medicine, two of my partners retired last year. Despite the promise of a superb lifestyle for practising family medicine, we have had only one genuine inquiry for these positions after six months of advertising - and that was from another rural doctor.

Later this month the AMA will release the results of arguably the biggest-ever GP work force survey, which was conducted for us by Access Economics.

This survey tells a different story to the Productivity Commission. It tells a real life story of overworked doctors with low morale considering leaving the profession they love, and it tells the story of country towns and communities crying out for basic medical services that other Australians take for granted.

The story of medical services disappearing from regional and outer-suburban Australia is being told too frequently now for our political leaders to go on ignoring the problem.

Doctors who have hung on out of altruism and dedication to their patients can no longer afford to do so. It is taking its toll on their own health, their lifestyle and their livelihood.

Rather than adopt an ignorant attitude like some academics who say doctors should be coerced to practise in country areas 'like other public servants', a more reasonable and achievable plan for the longer term must be formulated.

We need a plan to get young doctors to country towns and the outer suburbs of our cities and provide incentives for them to stay there to grow with their communities. Provision must be made for employment prospects for spouses or partners. Choice of quality education for their children must be available. Access to holidays is vital, as is access to locums.

TRDs, overseas-trained doctors and part-timers do a good job filling the gap. They ease the problem for a time, but they do not solve it. Family medicine is a key component of contented communities. The family doctor is a family member for many patients in country towns and suburbs. Let's get them there and keep them there for the long term.

I hope that government decision-makers take more notice of our survey than the Productivity Commission when framing policy responses to what is a growing social crisis. The AMA will be actively encouraging them.

Dr Kerryn Phelps is President of the Federal AMA.