The pay and conditions of GPs must improve or the health system will continue to deteriorate and collapse, chair of the Hunter General Practitioners Association says.
"That's the elephant in the room," Dr Fiona Van Leeuwen said.
Her comments came in response to the Australian Medical Association [AMA] releasing its pre-budget submission for general practice.
The AMA is pushing for the federal budget, due in May, to ensure GP trainees are offered equal pay and conditions to their hospital counterparts.
This was needed to encourage more doctors to become general practitioners, given existing and predicted shortages.
The AMA has forecast an undersupply of about 10,600 GPs across the country by 2031-32.
The Hunter Region had 1086 GPs and registrars last year, but retirements are expected to shrink this number in the years ahead.
AMA president Steve Robson said public hospitals offer "much better pay and conditions in comparison to general practice".
"It's understandable that trainees will see the disparity in pay and conditions and not choose general practice," Professor Robson said.
He said GP trainees faced "inferior conditions for sick leave, carers leave, study leave, annual leave, long service leave and parental leave".
Dr Van Leeuwen said most GPs receive "no holiday pay, sick pay, superannuation or workers comp".
"You have to pay for that yourself out of your own income," she said.
Professor Robson said ensuring pay parity for GP trainees would have "an upfront cost", but patient care would significantly improve.
"This will help keep patients healthier and out of hospital and save health dollars in the long term," he said.
Specialists are paid much more than GPs. However, GPs believe they should be considered "specialists in general practice".
While the AMA's submission focused on conditions for GP trainees, Dr Van Leeuwen believes the focus should be on all GPs.
This was because GPs want to be paid well for their entire careers, not only as trainees.
Dr Van Leeuwen said it was already difficult for people to see a doctor in the Hunter "because there's not enough GPs".
"If these things aren't addressed, the health system will continue to deteriorate, which it has been doing rapidly for the last five to 10 years.
"And it will collapse. There needs to be a radical adjustment of the whole system.
"The siloing of specialties in medicine is counter productive to adequate and quality community care."
She believes the underlying structure of Medicare fails to support modern general practice.
The AMA has been advocating for increased Medicare funding, saying "the MBS [Medicare Benefits Schedule] no longer bears any relationship to the actual cost of providing services to patients".
Professor Robson said general practice was "the cornerstone of health care delivery in Australia, yet it's under significant pressure".
Patients were presenting "with increasingly complex health conditions".
The spike in chronic diseases such as diabetes and obesity, the ageing population and a rise in people with comorbidities had changed the role of GPs.
"If we are going to be serious about the future of general practice, we need to make it a more attractive career for all medical trainees," Professor Robson said.
