As another regional town loses its general practitioner, a long-standing Ballarat geriatrician has shared an "unpopular" opinion on how to address staffing shortages.
The last remaining GP in Smythesdale, 20 minutes south-west of Ballarat, relocated to another clinic in town last week, leaving residents without a local doctor.
Ballarat Community Health chief executive Sean Duffy said the decision was made to close the Smythesdale GP clinic after a review of medical services and an inability to hire a second doctor.
While the conversation about ways to address the regional GP shortage continues nationwide, Ballarat doctor Mark Yates said there should be a greater focus on the role of specialists.
Dr Yates said general practitioners were left unsupported and "vulnerable" without specialists in their regions.
"What concerns me most is that 50 per cent of general practitioners are, and we are lucky to have them, coming from overseas-trained environments where they have to work in the country.
"We don't have the specialists that actually make general practice a viable and invigorating and interesting practice."
Dr Yates said the concept was not "popular" among his colleagues, but suggested specialists setting up in areas that were already flooded with experts in their field should not be able to access Medicare rebates.
He said a new system was needed to incentivise specialists moving to regional areas.
"The question I think we have to ask ourselves as a community is if you have got 50 cardiologists within 5km of where you live, do you want your taxes to pay for the 51st to put up their shingle?" he said.
"There is no driver in the system to make that happen."
Bad news for Smythesdale
The Smythesdale GP clinic had been operating for about seven years.
Residents have voiced their concerns over the clinic's closure and limited public transport making travel to Ballarat difficult.
But Mr Duffy said the inability of Ballarat Community Health to hire a second doctor to practise at Smythesdale was a contributing factor to the closure.
"[It's] not something we see as good clinical practice to allow a GP to practise on their own," he said.
The Royal Australian College of General Practitioners (RACGP) announced a new Rural Generalist Fellowship last week, to advance rural generalist medicine and specialist GPs.
RACGP Rural Council chair Michael Clements said the fellowship was part of a response to increase the number of medical students moving to the regions and choosing general practice.
"One of the problems is only 15 per cent of medical students are indicating an interest in general practice when they leave medical school," Dr Clements said.
"It used to be 50 per cent and it probably needs to be 50 per cent to actually fill up all of the positions in all of the towns that need a GP."
Dr Clements said rural medical schools played a key role.
Mr Duffy said Ballarat Community Health had no immediate plans to reintroduce the GP service at Smythesdale, but he had been speaking to western Victorian doctors to see if any were interested in setting up a private practice in the town.
"We have had some interest and we have positive interest from one particular GP," he said.
"Our role is to help facilitate those discussions with the Golden Plains Shire and the community and hopefully we get a positive outcome."
Mr Duffy said Ballarat Community Health was not alone in deciding to consolidate services at larger sites.
"I have spoken to a number of companies and a vast majority, if not all, general practices are consolidating into larger general practices," he said.
"That is the reality of the cost of general practice. We haven't had substantial increases in Medicare rebates over the last decade so the cost of service delivery and the cost of compliance is forcing organisations to go down this consolidation path."