In his early days as a solo general practitioner in rural Queensland, Ewen McPhee remembers them as both exhilarating and exhausting.
"I have evidence I worked for three days without getting any sleep at all," he said.
Despite the long nights and mounting pressure, Dr McPhee ended up staying for decades in the central Queensland town of Emerald.
He said the turning point came with the arrival of the community-owned "super-clinic" in 2012.
"The growth in the number of clinicians required is very much related to the complexity of general practice," he said.
"It's no longer coughs, colds and runny noses; it's chronic disease management."
Dr McPhee said the community model had a specific focus on the education of young career doctors.
"We're also allowing Central Highlands residents and nurses to have opportunities to train," he said.
'Patchy' coverage
The peak body for GPs said there had been further federal investment in regional health care, but it was still up to local doctors to make use of it.
Royal Australian College of General Practitioners (RACGP) rural chair Michael Clements said a local practice's success came down to how well the three levels of government managed practice rents, hospital staff-sharing and Medicare exemptions.
"Generally, when a state government provides a health service, it's supposed to achieve that funding through national health reform agreements; they're not supposed to be tapping into Medicare," Dr Clements said.
"In rural and remote communities, there are exceptions."
Dr Clements has seen the changes himself.
His practice in Cloncurry in north-west Queensland was previously run by a single doctor stretched between hospital and general care.
When rebuilding the practice, Dr Clements said he secured agreements with Queensland Health and other health bodies to ensure trainees would be allowed to work in the remote town.
"The doctors are all salaried via Queensland Health with all of those entitlements yet still able to work from a community, privately owned general practice."
Dr Clements said the money made from those GP appointments from Medicare then went back to Queensland Health.
He said the Cloncurry council also helped guarantee accommodation and access to health care for staff, which gave the practice its best chance to succeed.
GP shortage easing
The latest figures from the RACGP and its counterpart the Australian College of Rural and Remote Medicine (ACRRM) show nearly 33 per cent of medical graduates were training to become either GPs or rural generalists.
That was music to the ears of John Burnett from community group Clermont4Doctors, who had advocated for more sustainable health care in his central Queensland hometown for close to a decade.
He said as far back as 1886, it was the Clermont community and not health authorities who made the town enticing for doctors, offering the modern equivalent of $150,000.
More recently, the town was left without a permanent GP in January, leaving not just Clermont but the broader agricultural region and drive-in-drive-out mine workers in limbo.
Mr Burnett said people were driving 200 kilometres for treatment, only to be told the doctor was busy.
"They go, 'Actually, I won't come back tomorrow, I'll just treat myself with a bit of aspirin and maybe a bit of sheep dip,'" he said.
The Royal Flying Doctor Service (RFDS) has stepped into the breach, opening a Primary Health Care Clinic in the town of 3,000 which will run until next year.
RFDS chief operating officer for clinical services Dom Tait said the organisation was "excited" to run a clinic from within the Clermont Hospital.
"We know how important it is to have continuity of care from your GP," he said.
"Our GPs will be fly-in and fly-out, but really importantly is those GPs are the same GPs on a rotation every four weeks.
"So, the community will get to know the GPs from the RFDS because it'll be the same GPs."
Finding the 'right recipe'
Dr Clements said the number of medical graduates taking on general practice was exciting, and he was optimistic more local practices could rebuild their training pipeline.
"It's actually competitive to get into GP training now," Dr Clements said.
"If you're a rural community and you've got the right recipe of a good, functioning practice with a good reputation for training, you can have a solution."
