Yarrawonga-based doctor Clyde Ronan has been working in general practice for 40 years.
Now 70, he says while he still enjoys the work, he has been thinking of retiring for some time.
"My days are pretty much numbered," Dr Ronan said.
"I'm in the twilight of my career and I should be handing over the reins to younger doctors to carry on."
But with a critical shortage of doctors in regional and rural Australia, those plans seem a long way from materialising.
Dr Ronan said the problem started with recruitment.
"Experienced doctors like me have been leaving and they haven't really been adequately replaced," he said.
It's a problem facing regional communities across the country, and it's getting worse.
'We're extremely concerned'
Rural Doctors Association of Australia president Megan Belot said the loss of GPs was more dire in regional areas than in metropolitan areas, and an urgent overhaul of the whole general practice system was required.
"We're extremely concerned about what the next few months will hold for rural and remote Australia," she said.
"We already know it takes weeks to get into your GP and we're seeing sicker patients presenting to our hospitals. It is really really concerning."
The exodus could be attributed to a combination of fatigue, burnout and not enough junior doctors coming through to replace those leaving, she said.
Some regional areas are offering huge salary packages in the hope of attracting doctors to communities in desperate need of medical services.
In South Australia, the health department recently offered an annual salary of between $475,763 and $752,224 for a general practitioner in the state's Mallee region, but most local health authorities don't have the capacity to offer such lucrative incentives.
Dr Ronan said his practice, which has four other GPs, was understaffed and always had been.
"If they up and left, I'd be on my own and the practice would be unviable," he said.
"I burnt out a long time ago but I kept working and I'm still working.
"We need to retain the doctors we've got. We need to look after them."
Change vital or 'communities will suffer'
Dr Ronan said more than half of the rural doctor workforce comprised people who came from overseas, and the local industry was too dependent on international medical graduates to fill gaps.
"We worked our way to the edge of a cliff and then when COVID came two and a half years ago, we actually started to fall off the edge of that cliff," he said.
There was a sudden urgency to recruit local doctors after international borders closed due to the pandemic but the numbers could not be met, resulting in shortages in metropolitan areas and worsening the already crippled workforce in the regions.
Dr Ronan said more focus needed to be placed on addressing the distribution of the workforce, by encouraging more doctors from metropolitan areas to relocate to the regions.
Dr Belot agreed.
"This has to be the time for change otherwise our communities will suffer," she said.
She's calling for urgent reform of the whole GP system — from updating bulk-billing and creating better working conditions and support for GPs, to making general practice a more attractive career for young doctors.
"We just need more amazing junior doctors to choose rural generalism as a career because it actually is an amazing career," she said.
"Junior doctors coming through want to stay in the hospital sector and make sure that they have their leave entitlements and educational entitlements and all those sorts of things that come with staying in the public sector.
"We need more support.
"We want to be treated on the same equity as our metro counterparts that are working in the hospital sector."
