Dr Robert Harvey, an ophthalmologist nearing retirement, is dismayed at the lack of action to find a permanent replacement after he recently resigned from a regional Victorian public hospital, creating uncertainty for 150 patients on his surgical waitlist and thousands more attending clinics for chronic conditions like glaucoma and age-related macular degeneration (AMD).
For several years, Harvey has worked in a salaried position with Portland District Health (PDH). Aged 69, he requested a contractual change that would have seen him become a visiting medical officer (VMO).
This would have allowed him to practise from rooms while still performing surgery at Portland’s hospital. Importantly, he said it also would have provided a pathway for him to seek and secure a successor VMO ophthalmologist for his patients, as he transitions to retirement.
Harvey finished at the hospital on 31 March, resigning due to frustrations with the hospital board who he said ultimately declined his VMO request. Without a permanent replacement, he is concerned about the erosion of specialist services in Portland with other medical specialties affected in a similar way.
PDH has denied the hospital is being closed, downgraded or amalgamated, but did expect ophthalmology services to be impacted in the short-term with Harvey’s departure.
Without a VMO opportunity, Harvey said few ophthalmologists would be enticed to take up his work in Portland on a salaried basis. Attracting eye doctors to regional areas is already difficult in Australia, an issue highlighted by RANZCO at its congress in February.
“I wanted to become a VMO so the service would carry on,” Harvey, who has worked in south west Victoria and south east South Australia since 2013, said.
“There hasn’t always been an ophthalmology service in Portland. There are plenty of people in the area and people are travelling long distances to see me already. Now that I’m gone, I’m worried it will fall by the wayside and people will find it harder having to travel to Warrnambool (102km) and across the South Australian border to Mount Gambier (108km).”
Harvey is also concerned about his 150-patient Portland public surgical waitlist that would need to be redistributed to other hospitals already under pressure.
“In Warrnambool, the waiting list for public ophthalmology cataract surgery is two years. I’ve got Portland patients who have already been waiting a year, so that’s not fair for them to wait longer again for public surgery,” he said.
“I’ve asked the Victorian Health Minister Martin Foley what is going to happen to those patients on the waiting list for surgery, and thousands of patients needing appointments for AMD, glaucoma follow up, diabetic retinopathy and anti-VEGF injections, but I’ve had no response.
“I’m particularly worried about anti-VEGF patients. One woman I see every month gets motion sickness so can only travel 2-3km in the car without getting severely motion sick, so this situation could lead to someone like her going blind.”
Harvey is continuing to work as an ophthalmologist in Mount Gambier and will increase his workload by one day a week to see the patients from Portland.
In a statement, PDH told Insight it recently accepted Harvey’s resignation, and thanked him for his service.
“Given this resignation and the challenges faced by all regional healthcare providers in recruiting specialist services, we anticipate some minor disruption to some of our ophthalmology services during April as we find a replacement, but we are confident this will be rectified very soon,” a spokesperson said.
“Our staff will be working hard to ensure any delays to service are minimal and that we provide continuity of care for patients. We know how important high-quality ophthalmology services is for our community and will ensure all community members continue to receive the care they need.”
Editor’s note: A more comprehensive report will be available in the May issue of Insight.
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