I’m among the doctors our system rejects. This is why regional healthcare is dying

August 13, 2026 — 7:30pm

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On March 4 last year, I received an email that, in one sentence, explains how regional health care dies. “Unfortunately, currently the [district] is not in a fiscal position to engage another gastroenterologist,” a senior manager wrote. “We can revisit this on an annual basis.”

I am a gastroenterologist in Port Macquarie. I’ve spent nearly 15 years caring for a catchment of a quarter of a million people, and until this year I was head of gastroenterology at Port Macquarie Base Hospital.

I had read a similar sentence before. In December 2019, the district’s then medical services director emailed us: “We are in no position to be recruiting a fourth gastroenterologist.” We had asked because three of us could not cover every week without burning out. One week in four each was sustainable; the fourth week had no cover. In April 2020, the hospital’s general manager conceded in writing that this was “a risk to patient safety”. The risk was documented. The fourth gastroenterologist was never funded.

In November 2024, the Royal Australasian College of Physicians, which accredits hospitals to train specialists, surveyed our department. The public gastroenterology service relied on........

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