Not enough doctors out bush? It’ll get worse as the climate warms

British climate researchers this week named Queensland on a list of most at-risk regions in the world for high-impact heatwaves, with the results published in Nature Communications.

In neighbouring Northern Territory, the “vast majority” of doctors already believe climate change is adversely affecting local health, as this 2021 study found.

But all this heat is having another human consequence – many doctors are considering leaving the NT and cite climate change as a motivating factor.

The doctors’ survey published in The Lancet Planetary Health suggested one-third of doctors might leave the Northern Territory because of rising temperatures.

Such a situation could result in even poorer health outcomes among remote populations in the NT and beyond, even though the regions already suffer some of the worst health statistics in Australia.

In the town of Katherine for example, about 300km south of Darwin, it’s an understatement to say the summers are reliably hot.

But in 2019, residents endured a year of hot spells that must have seemed interminable: 56 days above 40⁰C. Overall, the summer of 2019–20 was 4⁰C above the long-term average.

An aerial view of the township of alice springs in central australia. It's one of the towns in the nt that is likely to feel the impact of not enough doctors out bush.
Alice Springs is one of the Northern Territory towns that may struggle to retain medical staff in the future. Credit: Oliver Strewe / Getty Images.

In such conditions, a doctor’s mind turns to the increased likelihood of illness and death, or, in medical lingo, morbidity and mortality.

The NT has the highest rate of premature morbidity and mortality in Australia, with its Indigenous population having significantly reduced life expectancy compared to non-Indigenous Territorians.

People living in rural and remote areas generally have higher rates of hospitalisation, death and injury, as well as poorer access to and use of health services, compared to people in metropolitan areas.

But the NT also scores highest for potentially preventable hospitalisations, at more than double the national average.

Research has shown that shortages in the health workforce and an inequitable distribution of medical expertise are both barriers to improving health outcomes.

Low quality and poorly insulated housing are only making matters worse; no match for the hot conditions, such housing acts to increase the existing vulnerability of people with chronic disease.

On the plus side, there are a high number of medical professionals per capita in the NT, but there is a troubling level of variability and turnover in that number and localised staff shortages remain a challenge.

It has long been thought that heat might also be making working in northern locations less appealing to medical practitioners, but little was known about the specific effects of heat on health-care staff.

Read more in Cosmos: The growing toll of climate trauma on the mental health of Australians

“Climate change could decimate our rural health workforce,” said Dr Simon Quilty, aa long-time Alice Springs rural physician and ANU researcher.

“It’s the biggest threat to health; not only does heat itself kill, but it worsens existing healthcare inequity in places most vulnerable to extreme heat.
“The NT already has the greatest health inequity of any state of Australia, and climate change is rapidly compromising the few gains that have been made.”

A team of researchers from ANU that included Quilty surveyed 362 Northern Territory doctors to find that “climate impacts such as extreme heat could lead to health workforce shortages in rural and remote communities, which already struggle to attract and keep doctors”.

Of those intending to leave, 66 per cent reported planning to do so within two years, citing training, career development, job dissatisfaction, moving to a preferred location, and family-related factors as motivators.

The authors suggested rural workforce policy development was needed to improve medical workforce retention in the NT and emphasised that Australian health workforce strategies need to recognise and address climate change.

“We have no time to lose in urgently taking steps to protect Australians, in particular Territorians, and prepare our health sector and communities for worsening extremes,” says Quilty.

The Greenlight Project is a year-long look at how regional Australia is preparing for and adapting to climate change.

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