Sapphire Coast GP calls for general practice to be properly funded

Nine years on he has patients from Bemboka to Mallacoota, many of whom were alarmed at the situation at Eden's Curalo Clinic, Eden.

The clinic where Dr Kallinen works needs three to four doctors to make it financially viable but it's almost impossible to get one, let alone three, and so the clinic faces closure in a matter of months.

He wants to stay in the area and will have no trouble finding an alternative practice to work for if Curalo closes. Dr Kallinen said he was approached with job offers almost every day.

With the prospect of taking his patient list with him, at least his patients' future healthcare is guaranteed.

But he said the demise of general practice was like watching a train crash in slow motion.

"A small town GP is an 'everything doctor' from operating skin cancers to providing mental health counselling and everything in between. You are there monitoring children's development and attending to the palliative care of the elderly," Dr Kallinen said.

"My mortgage payments are inching frightfully close to my full salary, but I'm still committed to looking after my community of patients."

But, he said, without adequate numbers of GPs the system would collapse and desperate patients would start clogging up emergency departments.

"Specialists will no longer be able to discharge patients from their care and primary diagnostics will be delayed and people will deteriorate.

"We can't continue to guilt GPs into going into personal debt, providing medical care for compensation that won't suffice to keep the lights on.

"We need to make the job more attractive or no one will train to become a GP, and we need to find ways to incentivise going rural.

"We could easily index Medicare rebates by area of workforce shortage to make it lucrative for doctors to uproot their families and move to small towns where their work is most needed. This needs to happen soon, because the system is collapsing right now," Dr Kallinen said.

"Australia needs to start funding general practice properly and fast."

"You would think the Australian government was rushing to correct for this growing shortage of general practitioners, but the politics of recent decades have worked to the exact opposite effect," he said.

"In 2013, the Australian government enacted a Medicare Rebate Freeze as a "temporary" budget savings measure. In effect, the fee for service received by GPs was locked in a fixed dollar amount, whilst the cost of absolutely everything else kept going up with inflation.

"Consequently, an increasing number of clinics were forced to start charging a "gap payment" on top of the bulk billing rate just to make ends meet.

"Australian general practice clinics are run as private businesses. The only source of income for these clinics comes in the form of doctors billing patients for services rendered.

"Every part of the operation is funded by this sole source of revenue: rent, utilities, insurance, computer systems, medical equipment, reception staff, nursing staff.

"The Australian government appears to believe general practitioners can deliver a standard consultation for $41.40 and is quick to blame GPs of greed for no longer bulk billing their patients.

"Please understand, a general practitioners' entire income is some percentage of that, with a good share going into the running of the practice.

"Very few medical graduates look at this picture and decide it's a good idea to become a GP. Would you choose a lane that pays less than half of any other job you could choose, knowing it's also one of the most complex and demanding positions you could hold?" Dr Kallinen said.