Australia's shortage of general practitioners could soon force clinics to cut back on services and turn away patients unless the government intervenes, doctors and peak medical bodies are warning.
Rural practices have been dealing with the impact of the shortage for years and now the problem is increasingly being felt at metropolitan GP clinics across the country.
Blair Athol Medical Clinic practice manager Angela Lee said the Adelaide practice is struggling to keep up with growing demand.
"It's chaotic, the demand for medical services has just increased substantially," she said.
Ms Lee said reception staff at the northern suburbs clinic struggled to manage the volume of calls building up throughout the day, and patients were having to wait longer for available appointments.
"It's very much a madhouse in many respects but we're actually offering really critical care for patients," she said.
"If Blair Athol Medical Clinic closed, that's 14,000 patients, where are they going to go? Who's going to deal with them? Where can they get the medical care they need?"
Clinic owner Kamal Wellalagodage said many patients were affected by domestic violence, child abuse and drug and alcohol abuse.
"Most of the local graduates don't want to become a GP, and at the same time if they become a GP, they don't want to work at this kind of clinic," he said.
Last month, a two-year-old child was taken to the clinic with serious injuries before a 40-year-old man and a 34-year-old woman were charged with criminal neglect.
According to staff at the clinic, walk-in cases like that are not unusual, and while they try to accommodate, they are concerned they will have to start turning patients away unless they can attract more GPs.
Situation worsened by restrictions on overseas-trained GPs
The clinic is also facing the possibility of losing two of their overseas-trained GPs under rules which require foreign doctors to work in distribution priority areas like regional and rural locations, or only after hours in metro clinics.
"Blair Athol Medical Clinic has trained them and supported them through their fellowship, [but] they'll of course go to another practice," Ms Lee said.
Dr Wellalagodage has been calling on the federal government to allow an exemption to those rules so that the doctors could work during the day and assist the practice in meeting demand.
"We have a problem, and we have a solution also," he said.
So far, those requests have been unsuccessful and he believes it is only a matter of time before the clinic is forced to cut back on the services it can provide.
"I think we [will be] forced to close after hours because we can't accommodate that because we can't hire the doctors," Dr Wellalagodage said.
General practice 'under siege'
Australian Medical Association of South Australia vice-president John Williams said general practice needed more support.
"General practice and primary care has been under siege for some time with a decrease in Medicare funding over the past 10 years," he said.
"Previously, about half of medical graduates would go to general practice. Now, [it's] about 15 per cent."
He said if people can not get an appointment with their GP, it will add further strain to the hospital system.
He wants to see greater flexibility in granting exemptions for overseas-trained doctors in cases where clinics are struggling.
"We really need help in general practice, we really need the government to support us.
"This is an opportunity to build our health system, and to make it better for everyone, improve the health of the community and improve access," he said.
'Going from bad to worse'
The state government said it was looking at ways to attract more medical graduates to general practice.
"I do think we need to look very carefully at increasing the number of doctors coming through the system," SA Health Minister Chris Picton said.
"We've clearly got a problem where we can't even get the GP training positions filled with medical graduates who want to put up their hands to be GPs.
"That's a sign of the situation for general practice going from bad to worse rather than getting better."
"Clearly, there's an issue in terms of regional South Australia, there's now also an issue in outer-metropolitan Adelaide as well, and this is being felt right across the country."
In a statement, the federal government said it was investing almost $1 billion into Medicare and working on improving GP affordability and access.
