Nambucca Valley GP shortages and why it's so difficult to find replacements

Dr Paul Foster with colleague Dr Mark Smith who both now practise at Evolve Medical Centre (formerly called Peachtree Medical Centre)
Dr Paul Foster with colleague Dr Mark Smith who both now practise at Evolve Medical Centre (formerly called Peachtree Medical Centre)

Getting city-bred medical graduates to come and stay in regional parts of Australia like the Valley is like trying to nail jelly to a wall.

Or so says Dr Paul Foster, one of the longest-serving General Practitioners (GPs) in the Nambucca.

“And we’re all old guys now, there’s not a lot of young guys coming through,” he said.

“Every two years we’d get one applicant, and then we just stopped looking after a while.

We live in God’s-own country, but noone wants to move here.

And the reason for that? Well, if you’ve grown up in the city then that’s usually where your family, your significant other and their (usually professional) job, and all the other mod-cons you’ve become accustomed to, are.

“I call it the David Jones factor,” he said.

And he says that health professionals often breed other health professionals: “I talk to my students and ask them what their mums and dads do and most of them are doctors.”

So if we can’t attract doctors, like moths, from the big city lights, then is the solution to look internally?

“We just don’t put enough into medical school,” he said.

“And kids won’t get into medical schools from country high schools because their grades aren’t high enough.

“We really need more quality education.”

Macksville doctor, Nick Willcocks, retired in 2013 after nearly three decades as a GP in the Nambucca, and starting Star St Medical.

Macksville doctor, Nick Willcocks, retired in 2013 after nearly three decades as a GP in the Nambucca, and starting Star St Medical.

States have tried to tackle shortages of educators in regional, rural and remote Australia by offering teaching graduates placements in these high-need areas.

In fact, most young teaching grads do not have the luxury of a choice between a cushy city job and one out in the bush.

But when asked if this would be a viable option for the health industry, Dr Foster was skeptical.

“I can see the attraction of doing it, but I don’t see anyone wanting to take it up,” he said.

And the AMA [Australian Medical Association] is a politically dangerous animal – you try taking on the AMA.

While rural areas often get the political carrot of doctor retention grants, the Mid North Coast is no longer classified as an ‘area of need’.

“But I think there’s been a political change in the area of shortages, and I think we’re more so an area of need than ever before,” Dr Foster said.

Having interviewed countless locals who have shared horror stories of having to wait nearly a month for treatment for a range of debilitating or chronic illnesses, it’s hard not to agree with him.

And most doctors in the Valley have closed books; they average 2000 patients versus the city doctors’ 300 or so.

Dr Foster estimates that we are currently five GPs short in the Nambucca Valley and his real concern is that with the ageing population of practising doctors here, the Valley’s situation is about to get a lot worse before it gets any better.

“If you’re looking for a quick way to attract doctors, you won’t find any. I’ve been looking for a long time and I haven’t found one yet,” he said.

“The cynic in me says it won’t change during the course of my career.”

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But there are the occasional glimmers of hope, too.

The Nambucca Healthcare Centre has just taken on two new locum doctors and is currently welcoming new patients.

Evolve Medical Centre (formerly known as Peachtree) now has a full complement of doctors on board and will very soon accept new registrars and medical students.

The first sod will be turned on the new and increased-capacity Macksville Hospital this year.

And the ‘Future Health Champions Expo’ at Bowraville Central School on Friday did as much to inspire hope as it did to inspire Indigenous kids to consider a career as a health professional.