Amid surging patient wait times for paediatric care across NSW, one South Coast GP has been investigating ways to provide families with the services they desperately need.
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Batemans Bay GP Dr Michelle Hamrosi said her Surf Beach practice had experienced constant roadblocks when trying to find paediatricians who were available, timely and affordable.
It's a story repeated across the state. For rural and regional families, finding a paediatrician is a nightmare with one Wagga Wagga doctor calling it a "national crisis".
Wait times are about 18 months and can balloon to six years depending on where you live.
Tamworth has a wait time of up to six years, Wagga three years, Orange two-and-a-half years and Coffs Harbour and Bega around two years.
With most paediatricians centred in capital cities, Dr Hamrosi said parents are growing increasingly frustrated.
"The parents get pressure from schools," she said. "It's a complex thing and so parents are pulling their hair out at home.
"(They're saying) 'I really need to start getting some support with this but, hey, my wait time is unknown, it could be 18 months'."
Sustain Trial
A specialist in child health and breastfeeding, Dr Hamrosi is six months into a trial giving GPs access to the state's largest paediatric centre at Sydney's Westmead Hospital.
The trial, called the SUSTAIN project, can be a positive step in reducing the wait, by connecting specialists and patients virtually.
Dr Hamrosi said the program is unlikely to solve the huge challenges faced by the paediatrician shortage in regional NSW, but it does help get the "ball rolling" in getting a child assessed.
"I'm so pleased to have this available," she said. "I'm fairly confident in paediatrics but when it comes to certain areas, for example, allergy - you can't prescribe an EpiPen unless that child has been seen by a paediatrician or allergist.
"Sometimes you can be really stuck for a family and I just had a co-consult on that very issue.
"Now that child is on a waitlist to see an allergist in Canberra but it's not as urgent. We have a plan and they'll get reviewed eventually but they're not sitting there for 12 months waiting with an anaphylaxis to nuts without an EpiPen."
The other option would be an expensive trip to Sydney, where waitlists are still long, Dr Hamrosi said.
Funding needed
Dr Hamrosi said the program would only succeed with more government funding.
The co-consults run at least 30 minutes and often longer, making bulk billing unsustainable for most practices.
The issue feeds into a GP shortage in regional NSW, Dr Hamrosi said - mainly because the numbers don't stack up.
"If you don't have GP appointments to get into to do the co-consult with the paediatrician then this model won't work," she said.
"If you want to provide that really comprehensive care a longer time is needed but you're remunerated for short appointments in general practice.
"In the world we live in today, the increasing complexity of people's medical problems requires longer appointment times."
Her practice is always investigating how to reduce out of pocket expenses for their patients, but it's becoming harder.
"We're really focused on serving the community but obviously we want to be financially viable," she said.
"We want to attract new doctors to the area too and students to do this. If you're saying you're working like a dog and you basically don't make much money (it's not attractive)."
Call for action
Children's health charity Royal Far West (RFW) said it regularly receives phone calls from GPs across the state about the lack of paediatric access. Most of the regional paediatricians have closed their books to new patients.
RFW operates one assessment centre, at Manly on Sydney's northern beaches.
The charity is calling on the government for funds to set up a three-year pilot program to expand its developmental assessment and treatment service. The new paediatric assessment clinics would be at Wagga Wagga and Dubbo.
NSW health minister Ryan Park told ACM he recognised the challenges many regional families faced in getting an appointment with a paediatrician but did not commit to Royal Far West's proposal.
For full coverage of the campaign to increase paediatric services in NSW visit here.