How do we get young grad­u­ates prac­tis­ing in coun­try towns?

Central and North Burnett Times - - NEWS -

GAYN­DAH’S Dr Henry Ung, who on Fe­bru­ary 2 will cel­e­brate his 50th year of prac­tice in the coun­try town, is look­ing for­ward to his re­tire­ment.

But it’s not so much a ques­tion of when but of who – as in, who will re­place him? To that end, Dr Ung does not get to choose when he re­tires. He is de­pen­dant on a sys­tem that is cur­rently strug­gling to pro­duce enough bush GPs to re­place those near­ing the ends of their ca­reers, im­port­ing 2000 for­eign-trained doc­tors per year to keep abreast of the at­tri­tion rate.

In 2013, Dr Ung’s part­ner in the prac­tice de­parted to Bar­gara af­ter re­ceiv­ing a se­cond med­i­cal de­gree and has not been re­placed. The ef­fect was twofold. Pro­fes­sion­ally, it meant Dr Ung could no longer work with Gayn­dah Hos­pi­tal, as he had no one else to look af­ter his prac­tice. Per­son­ally, it meant his al­ready scarce hol­i­day time be­came prac­ti­cally non-ex­is­tent.

Dr Ung took a week’s hol­i­day over Christ­mas but said this was not an an­nual oc­cur­rence by any means.

His long­est stretch sans break was three years, in the 1980s.

There’s no in­cen­tive for young grad­u­ates to prac­tise medicine in the bush, Dr Ung said dur­ing a rare win­dow in his daily con­sul­ta­tions.

“Most ru­ral prac­tices are bulk-billing, whereas in the big cities with the Medi­care fee sched­ule they can charge $80–100 for a con­sul­ta­tion. Here we are get­ting $36. So they are think­ing why see three pa­tients when I would only see one in the city?

“So the only way is to get doc­tors from over­seas, be­cause those doc­tors would get a month’s wages, or prob­a­bly six months, in ru­ral Pak­istan for in­stance, in a week.”

Even then, Dr Ung said, for­eign-trained GPs only tend to spend a cou­ple of years prac­tis­ing ru­rally, be­fore “zoom!—back to the cities and the next mob come”.

Dr Ung said that he and Gayn­dah Hos­pi­tal had helped train well over 100 med­i­cal stu­dents as part of their so­cial and pre­ven­ta­tive medicine course re­quire­ments, but that he isn’t aware of any who stayed.

“I think they use this as a step­ping stone. None of them over the years turned to ru­ral prac­tice. None of them came to the coun­try. They wanted to be­come fa­mous heart sur­geons.”

Dr Ung sug­gests a con­di­tional schol­ar­ship where re­cip­i­ents are re­quired to spend two years prac­tis­ing in the coun­try as a way of at­tract­ing young doc­tors.

“They might like it, like me. Give it a chance.”

Wife Elaine, who man­ages the prac­tice, thinks the big­gest bar­rier is em­ploy­ment for part­ners and spouses.

”Doc­tors don’t marry nurses any more, they marry other pro­fes­sion­als. If they are high-fly­ing ac­coun­tants or en­gi­neers... there aren’t jobs for them.”

A 2017 po­si­tion paper from the Aus­tralian Med­i­cal As­so­ci­a­tion ti­tled Ru­ral Work­force In­cen­tives echoes many of the Ungs’ con­cerns.

In a list of “fun­da­men­tal rea­sons why ru­ral ar­eas are not get­ting their fair share of the med­i­cal work­force”, they in­clude “in­ad­e­quate re­mu­ner­a­tion” and “poor em­ploy­ment op­por­tu­ni­ties for other fam­ily mem­bers, par­tic­u­larly part­ners”.

Ac­cord­ing to the AMA, some steps which could be taken to en­cour­age ru­ral prac­tise in­clude mo­ti­vat­ing ru­ral stu­dents to en­rol in med­i­cal school, pro­vid­ing flex­i­ble work­ing ar­range­ments with locum re­lief, sub­si­dis­ing hous­ing, and pro­vid­ing tax re­lief or a ru­ral load­ing.

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