Rural doctor crisis: Tristar founder fears ‘disaster’ for communities

Source: (Sunraysia Daily, 2.7.2018)

Australia faces a public health crisis in rural communities, the founder and chief executive of Mildura-based Tristar Medical Group has warned. Dr Khaled El-Sheikh said the problem of doctor short­ages in small towns was being exacerbated by rules regulating supervision of training doctors. He said the restrictions had made it a “nightmare” to replace doctors who leave small towns.

“It is a disaster, it is a crisis and if there’s nothing done about it extremely fast, we are going to have serious health issues in smaller communities – and it will only get worse because you can not stop a doctor from moving,” he said.

Tristar has 58 clinics, mostly in rural and regional areas, across each mainland state except Western Australia. Dr El-Sheikh said several changes in the past 14 to 18 months were behind the looming crisis. The “straw that broke the camel’s back” was a requirement every clinic with supervision needed to have a fellow (a doctor with training qualifications) on site. He said for many communities, it was unsustainable to have more than one doctor.

“You look at Wentworth … it cannot sustain, financially and operation-wise, (having) two full-time doctors,” he said. “So if you do have that magical fellow, who can supervise and has decided to live and work in Wentworth, they can’t afford to have (a doctor under supervision) because there’s not going to be the income.”

Dr El-Sheikh said this followed restrictions on how many doctors a fellow could supervise, which he said prioritised numbers over the quality of training being given. Doctors were also now being asked to wait three years after gaining their fellowship before they were allowed to supervise, he said.

“Your pool of doctors who are able to supervise has shrunk.” Last month’s Federal Budget allocated $95.4 million for country-based medical training, including the establishment of the Murray Darling Medical School Network. Dr El-Sheikh was supportive of the initiative to start regional schools but said something was needed in the short term. He said larger clinics in regional centres, such as Mildura, had a “lesser risk” of being affected by the recent changes, but they weren’t entirely in the clear.

“In Mildura, we’re still fortunate because we have great doctors and great fellows, but God forbid we lose one of our fellows. “You then have no supervisor, so bad luck Mildura.”

Dr El-Sheikh said he wanted more thought given to the impact regulations were having on small communities and was happy to speak with politicians or health officials to provide feedback.

“At the ground level, from where I sit, we’re looking at a disaster,” he said. “I’m not a person who will run and talk and go bananas, I’m very conservative. “I only speak, the only fight I will take … is when I start to see it have a serious impact on public health and services provided, which I’m starting to see very clearly now in black and white.”

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