Bega GP Duncan MacKinnon agrees there are extra burdens to running a GP clinic in a rural area that aren't experienced by medical specialists.
The National GP of the Year for 2020's comments come as several Bega Valley GPs warn of looming closures in the district, with clinic owners at or nearing retirement age and multiple challenges facing recruitment.
Dr MacKinnon said GPs receive less money and deal with more administration.
He should know because as well as running his practice for over 25 years, Dr MacKinnon is also a visiting medical officer (VMO) at South East Regional Hospital and a GP anaesthetist.
In addition, in rural areas they do more for their patients because they "are it" and the patients can't be moved on to a specialist down the road.
He quotes office support for GPs and surgeon consultants while they are working at the hospital.
"As a GP while you are in the hospital as a VMO you get $20 an hour for office support, but it's $120 for a surgeon consultant and they have considerably less in their offices.
"A GP would have temperature monitored fridges for vaccines, nurses, other medical and IT equipment which a surgeon wouldn't need."
It's not just the support but also the pay - he says he can earn twice as much working at the hospital.
"It's a reflection of how GPs are supported by Medicare," Dr MacKinnon said.
"I love the work I do at the hospital but I also love the work as a GP too."
As a further example he cited the GP accreditation process at a cost of $7000-9000 every three years - something specialists don't have to do; the Medicare rebate for GPs which doesn't cover all their costs; admin compliance - something he says costs about $40,000 a year; and the constant updating of medical practise which is a matter of continual education.
"GPs are doing 10-12 hour days but their support and protection is underwhelming. We are the poor relatives of the medical world."
However, Dr MacKinnon said there were very good reasons why GPs should receive at least equal treatment.
He said studies showed in countries where there were more specialists than GPs the longevity of the population was lower.
"The more GPs you have the longer is the longevity. Primary care is important."
Like other local GPs Dr MacKinnon said bulk billing doesn't work in a rural practice.
"Bulk billing is six minute medicine. My standard consultation is 20 minutes but Medicare pays the same.
"We have ownership - if the problem is not fixed, it will come back to me."
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He said in a big city, bulk billing centre patients get sent off to see a specialist and if they do return, they were unlikely to see the same doctor each time.
In late April the Coalition announced initiatives worth $146 million to support medical practices, increase the services available and build the medical workforce in rural and remote Australia. Labor has also made the same commitment.
Rural Doctors Association of Australia (RDAA) president Dr Megan Belot said it was a relief to see strong support for health policy to support "real rural".
"This is a model developed by RDAA in collaboration with the first Commissioner for Rural Health Professor Paul Worley and other peak general practice bodies, which will see doctors working in rural and remote areas receive increased loadings to their remuneration that recognises the provision of quality general practice and the extended scope of service that many of these doctors provide," Dr Belot said.
"It will be a strong improvement and retention payment for the senior doctors in these communities, and also a significant uplift in remuneration packages to attract highly skilled and motivated rural GPs and Rural Generalists to the areas that need them."
Dr MacKinnon said he was heartened by the announcement but said the devil was likely to be in the detail.
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