Sarah McLay is the last GP standing in the central Queensland town of Clermont and she faces an impossible choice between the town and her family.
"I have sacrificed a lot of my children's youth to service this town," she said.
"I don't know how much longer I'll be able to keep going."
Three years ago, Dr McLay, with two young children in tow, opened Clermont Country Practice in the town of 3,000, west of Rockhampton.
"It's very hard to make those ethical decisions and choose your family, which is what you need to do," she said.
"I can't keep losing money and losing my family and working myself into the ground for everybody else's best interest."
Other GPs have come and gone and, so too, have locum doctors at the Clermont hospital.
Cattle producer John Burnett said Clermont was the canary in the coal mine amid a national doctor shortage impacting rural areas.
"If our government can't fix Clermont, we won't get there," he said.
"My next best option will be the vet up the road. If Dr Sarah leaves, we won't have a doctor in town we can rely on.
"My pets have continuity of care, and I don't … our local GP is so critical to the survival of communities in the bush."
Dr McLay said Clermont was experiencing a collection of pressure points.
"We are the people that lost doctors first," she said.
"We are the people that have the most complex patients without all the resources."
'Not cutting the mustard'
Mr Burnett is a member of the community group called Clermont for Doctors that has been trying for years to attract and retain permanent doctors for the town.
The Mackay Hospital and Health Service (MHHS) created a model for a sustainable workforce, but so far it hasn't worked in Clermont.
"We found doctors who were prepared to come and live in rural areas," he said.
"We've tried to have them employed in the medical system and unfortunately the system has failed to provide those doctors' needs, and what our community needs."
Mr Burnett says further action is needed.
"Talking about it just isn't cutting the mustard," he said.
"We need four permanent doctors, not just four locums coming and going."
In a statement, the MHHS interim chief executive Paula Foley said it had "recently undertaken a national and international recruitment drive for medical officer positions".
In 2021, the federal government announced a $500,000 recruitment package for a registered GP to train in Clermont.
Camilla White took up the opportunity, but at the end of August, she moved back to New South Wales, citing family reasons.
The salary support funding came from an Extended Targeted Recruitment pilot that was part of the Remote Vocational Training Scheme Program.
The Health Department says the pilot is underway until the end of December.
It's Dr McLay's understanding that funding will be available to another registrar GP if they apply before the end of the year.
'My heart will be broken'
Long-time locals of Clermont are worried the doctor they have relied on for the past three years is close to breaking point.
Leonie Keune was diagnosed with breast cancer earlier this year and for her, Dr McClay has been her rock.
"Even though I've had to travel to the city for treatment … Dr Sarah has been my one constant," she said.
"As a mother, I understand how hard it is to be away from your children.
"I've had phonecalls [for her] when she should be home with her children, but she's the only doctor in town."
Carmel Smith said she used to travel to Moranbah and Emerald to see a GP.
"When we had Sarah come to town, it seemed to be the solution to all our problems, but she can only do so much," she said.
"If she leaves, my heart will be broken."
GPs on the brink
A recent report by the Royal Australian College of General Practitioners (RACGP) found 73 per cent of GPs experienced feelings of burnout in the past 12 months.
In addition, almost 50 per cent indicated it was financially unsustainable to continue practising, and 70 per cent of practice owners were concerned about the short and long-term viability of their business.
For Dr McLay, it's been a struggle since the start.
"In the last 12 months, we've lost $200,000, and that's directly related to the anticipation of doctors that didn't come," she said.
"When I first opened, we couldn't afford to bulk-bill and then the changes in access by the government happened and before we knew it, we were bulk-billing hugely."
Now, Dr McLay must turn to the community and increase her prices.
"I don't think there's a doctor coming," she said.
"And I don't think I could look at that doctor and say I'm about to leave you on your own.
"At the end of the day, I gave it my best and I tried my hardest [but] it's not just on me anymore."
