Jessica Harris never expected she would have to fight so hard to find a paediatrician for her son.
"It's really disappointing as a mum wanting to advocate for your child and wanting to get them help as soon as you can, and not being able to physically access that," she said.
Two-year-old Arthur needs specialised care for a foot issue, but it has been hard to come by.
"Trying to find a paediatric podiatrist locally has been impossible," Ms Harris, who lives in Kiewa in north-east Victoria, said.
The family has been referred to specialists from Wagga Wagga to Melbourne.
They have even resorted to seeking help in Singapore via telehealth.
The family now travels several times a year to Melbourne for specialised care, but it is a multiple-day inconvenience and requires time off work.
Ms Harris is anxious to address the issue in her son's critical early developmental years.
"If we had have had access when Arthur was younger to some of those specialist doctors perhaps we could have had him treated earlier," she said.
"We know that when children are treated younger they have a reduced recovery time."
Over the valley in Yackandandah, mother Louise Rietmann said she had been waiting months for answers after her one-year-old son began showing signs of anaphylaxis around last Christmas.
It is at least a half-hour wait for an ambulance where she lives, so she nervously carries around an EpiPen prescribed by her GP just in case a life-threatening reaction strikes.
She cannot get in to see a local paediatrician until July, and has struggled to get in to see specialists in Melbourne.
"We have just been told to avoid egg and all traces of egg until then which is really difficult," she said.
Painful waits
Albury Wodonga Paediatric Group has closed its books as its three paediatricians are swamped with 150 referrals per week.
In a statement to the ABC, a spokesperson for the group said: "We simply do not have the capacity to see all referred children."
"At this time the Albury-Wodonga Paediatric Group cannot accept new patient referrals for non-medical issues, ie. developmental and behavioural issues unless an immediate member of family is a current patient," they said.
"There is a local public community service accepting developmental and behavioural referrals for children aged up to eight, however we understand this service is also very stretched."
The problem is being felt across the country as surrounding regional and metropolitan services are also restricting medical referrals.
At the Wangaratta Paediatric Clinic, doctor Terry Stubberfield said his team had 500 referrals to filter through, many of those new patients.
He said the clinic's appointment book for the entire year was already full, particularly as families from other regions had begun to trickle in searching for appointments.
"We try to meet the urgent referrals but obviously there are going to be people who are on the wait list for quite a while," Dr Stubberfield said.
He said an increase in the complexity of cases inundating his service was impacting appointment availability, as well as the additional administrative commitments associated with that.
"I am aware that 12 months, 18 months is not unusual for people [to be] waiting," Dr Stubberfield said.
Paediatricians are also struggling to work under a Medicare system that they say no longer keeps up.
Some Medicare items for the most complex cases paediatricians are seeing, like neurodevelopmental disorders, require comprehensive assessments and the development of interdisciplinary treatment and management plans.
But many are limited to at least 45 minutes and claimable once in a patient's lifetime.
"Medicare support is currently not appropriate for the level of complexity and time required and I think a redress would help some general paediatricians feel they can then offer that sort of service," Dr Stubberfield said.
Call for urgent reforms
The Royal Australasian College of Physicians has also pushed for the problem to be addressed.
"There's a crisis in paediatrician wait times across the country and we are very concerned," RACP president and paediatrician Jacqueline Small said.
"Paediatricians are being inundated with complex cases and are having to close their books because the load has been increasing over time."
The RACP has reported a spike of mental health issues in children and adolescents compared to before the pandemic, and wants reforms to help ease these pressures.
It is also pushing the federal government for more specialist training positions across the nation.
"In the federal budget, the government announced it will boost incentives to expand multidisciplinary team care in primary care settings," Dr Small said.
"The government must urgently include specialist care, including paediatric care, into these reforms so that patients, including children, young people and their families, can access the services they need. "
A Department of Health and Aged Care spokesperson said in a statement:
"The Australian Government's Specialist Training Program (STP) comprises up to seven per cent of specialist medical training in Australia, with the remainder supported by state and territory governments and the private sector.
The STP extends vocational training for specialist registrars into settings outside traditional metropolitan teaching hospitals, including regional, rural and remote and private facilities.
The program also aims to contribute to enhancing availability of the specialist workforce in areas of unmet community need, including in rural and remote locations.
The agreements comprise $708.6 million for four years across 2022-2025, equating to 920 full time equivalent (FTE) specialist training places and an additional 100 FTE places for the Integrated Rural Training Pipeline annually.
The Australian Government continues to fund 1 Full Time Equivalent in Albury Wodonga in the sub-speciality of General Paediatrics."
