Sydney-born doctor Ariah Steel has managed a stroke patient, seen a baby being born and worked in emergency — all in a week of GP training in a small country town.
- A pilot program in the Murrumbidgee region allows GP trainees to work in hospitals with long-term contracts, a salary and entitlements
- The NSW Regional Health Inquiry recommends the program be expanded to help address doctor shortages in rural areas
- The federal government intends to try the model in other regional centers as part of a $146m rural workforce commitment
Dr Steel is part of a pilot training program with the Murrumbidgee Local Health District (MLHD), in southern New South Wales.
Under the program, trainee GPs work in state-run hospitals, as well as privately run clinics, and are paid by a single employer; the MLHD.
“You get to look after a whole community because you’re not just working in the GP clinic, you’re coming into the hospital, you’re looking after people in so many different ways,” Dr Steel said.
Dr Steel said, other training pathways, this model also provided a salary and leave entitlements.
She said many of her peers undertaking GP training took a pay cut when they got into clinics because they worked fee-for-service.
“You’re getting paid based on the patients you see and the wage isn’t great,” she said.
“Working under this new model, I’m getting paid a salary, I get annual leave, maternity leave, I get public holiday loading and I get paid my overtime, which is awesome.”
Finley doctor and MLHD director of primary health Alam Yoosuff said the model made it more attractive for students to train as GPs.
Dr Yoosuff said about 16 per cent of 3,000 medical students across Australia did general practice, compared to nearly 40 per cent seven years ago.
“We need people to do the holistic care in a generalist way, to provide aged care, emergency department, hospital inpatient as well as community general practice,” he said.
“This is the model that will give the best bang for buck.”
Building capacity in small towns
After one year of her GP training Wagga Wagga, Dr Steel moved to Deniliquin, in the southern Riverina.
“I think Deniliquin is a really special place and I feel so supported,” she said.
“I’m so lucky, because I get to work independently, which is great for learning, but if I need help it’s only a phone call away.”
She was a welcome addition to a community that has felt the impact of health workforce shortages.
Beds were closed at the Deniliquin Hospital during COVID-19 because of a lack of staff and in July expectant mothers were advised that no midwives would be available at the hospital on weekends.
Member of the United Hospital Auxiliaries of NSW and Deniliquin health advocate Pam Ellerman has welcomed the initiative to entice more doctors to the region.
“Deniliquin has been very short on doctors and it has been very difficult for someone to arrive in this town, almost impossible to put themselves on a GP list,” Ms Ellerman said.
“So if you can’t take any more patients, people are going straight down to accident and emergency.”
A model for other regions
The NSW Regional Health Inquiry recommended expanding the MLHD model but it needs co-operation from the federal government, which is responsible for general practice funding.
In a statement, federal Health Minister Mark Butler’s office said the government was planning an expansion of the single employer model trials for GP registrars, with organizations and selected next year.
NSW Regional Health Minister Bronnie Taylor has called for the model to be extended throughout her state.
“We know it works, we know it keeps GPs in our communities, we know it allows them to follow through with that rural generalist practice training, which is what we need,” she said.
“We know when we can work together with the federal government, we can potentially have really good outcomes.
“We’ve done it in New South Wales — back us in and let us roll it out!”