Calls for recognition of ‘isolated’ rural challenges as GP quits

When Dr Cameron Hoare took his first holiday as a registrar, he burst into tears as soon as the flight overseas lifted off the runway.
 
Having ‘easily’ been working 80-hour weeks plus on-call hours since he first came to the small rural Queensland town of Cloncurry, Mitakoodi Country, in 2015 as a general practice registrar, the burnout caught up with him.
 
‘Providing good high-level care to a remote community is a massive strain,’ Dr Hoare told newsGP.
 
‘[As a registrar] my supervisors, mentors and co-workers over time fought very hard to get some changes in place to increase the sustainability of working rurally.’
 
In 2021, Dr Hoare spent a year ‘resting and recovering after years of strain’, working 40 hours a week at the Toowoomba emergency department before returning to Cloncurry in 2022 and taking over the Ramsay Street General Practice, as well as becoming the medical superintendent of the Cloncurry Hospital that same year. 
 
Fast forward a few years and Dr Hoare, despite his selflessness and determination to continue providing healthcare to his small community, has had to make the ‘difficult decision’ to leave his practice after the workload of his job share became increasingly heavy.

‘The responsibility of managing two separate health systems – the hospital and the private practice – whilst providing good clinical care, good clinical governance, supervision of registrars and medical students, and maintaining financial viability, is a massive strain,’ he said.
 
‘I started to become particularly unwell in late 2024 when the only other Fellowed doctor in town took maternity leave, which significantly increased my share of the responsibilities.
 
‘It was the impact that my mental health was having on my ability to provide good medical care, and the impact it was having on my loved ones that was the final nail in the coffin.’
 
The only private GP clinic serving the Cloncurry community, which has a population of around 3600, Ramsey Street General Practice has operated five consultation rooms for decades, comprising local GPs, visiting locums, Aboriginal and Torres Strait Islander health workers, and allied health services.
 
News of its closure came earlier this month, as other practices around Australia struggle to keep doors open amid financial burdens and workforce shortages.
 
While Dr Hoare says his practice is financially viable and work is progressing towards having ongoing GP services in town via the practice from 1 July, the juggle of running it alongside his medical superintendent role at the local hospital became too much.
 
But he is determined to ensure that his community is not left high and dry.
 
‘I have had to make the decision to leave,’ Dr Hoare said.
 
‘I am still working with several stakeholders to ensure there is some ongoing access to care in Cloncurry.’
 
The North West Hospital and Health Service, which operates the Cloncurry Hospital, is considering options to ensure healthcare can continue to be provided to the community, including the proposed purchase of Dr Hoare’s practice to operate it under Queensland Health, similar to other rural and remote healthcare services.
 
RACGP Queensland Chair Dr Cath Hester, who worked as a junior doctor in Cloncurry, recently told the ABC this is another example of the need for better solutions and systems to support the rural healthcare workforce, including increased Medicare funding – a key Federal Election advocacy ask from the RACGP.
 
‘Until these measures start to take effect, over the coming years [these services] will need extra support so that they can keep their doors open and continue to care for their local communities,’ she said.
 
‘We can’t keep relying on the heroics of individual doctors to keep these communities cared for.’
 
For Dr Hoare, if there was one thing that could have been done to keep him as a practice owner, it would be more acknowledgement of the unique challenges that rural communities face.
 
‘There needs to be recognition that rural medicine in a low-resource isolated environment is very challenging,’ he said.
 
‘Especially if you care about the community. It is very easy to live a locum life, fly in, work for a bit and leave, as you do not take on any responsibility for ongoing care, or outcomes.
 
‘However, to provide good long-term care requires an element of responsibility and ownership, and supporting doctors to be able to provide that is very important.’
 
With plans to leave his clinic by June, Dr Hoare is currently formulating for the future, while also continuing to provide clinical care at both the hospital and the general practice, and providing clinical oversight at both.
 
He recently told the ABC his decision to sell the practice is somewhat of a double-edged sword.
 
‘I felt so light knowing that this strain and burden on my health wasn’t going to be there anymore,’ he said.
 
‘But it felt devastating that this is another rural community where primary healthcare has just failed.’
 
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