Inner Sydney’s HIV-positive population faces a shortage of sexual health doctors, as strict training requirements and difficulties obtaining a Medicare provider number deter physicians from entering the field, two leading HIV doctors claim.

Dr Robert Finlayson, director of Taylor Square Private Clinic, told Sydney Star Observer restrictions on the allocation of Medicare provider numbers, to recent local graduates and overseas trained doctors meant fewer doctors were opting to practise in sexual health in the inner city.

 There’s no shortage of people who want to work in sexual health and HIV in the inner city. Several of them I know are unable to because of this provider number restriction, he said.

 Although many of them would like to work in the inner city and work with HIV or sexual health or gay men, this is an obstacle to recruiting people, Finlayson said.

The restrictions on Medicare provider numbers -“ a prerequisite for claiming Medicare rebates in private practice -“ can be relaxed if doctors agree to work in so-called Districts of Workforce Shortages, usually regional areas with less than the national average of medical services.

But this limits the number of sexual health doctors available in urban areas, home to the most HIV-positive people, Finlayson said.

The rigorous training requirements HIV doctors face are an added deterrent, according to Dr Dick Quan, a director at Holdsworth House medical practice in Darlinghurst.

Quan told the Star training requirements, among other factors, were a powerful disincentive for GPs wishing to work in HIV medicine.

To be able to prescribe anti-HIV medication, doctors must obtain an s100 certification -“ a reference to section 100 of the National Health Act under which physicians are empowered to prescribe anti-HIV drugs. They must also complete ongoing training in the sexual health field.

Quan said the training obligations were costly and he called for increased government spending on HIV medical practices.

Finlayson said HIV patients faced more difficulty getting appointments, although the problem was not yet acute.

The doctor shortage that is being experienced now is only going to get worse.

But Australasian Society for HIV Medicine (ASHM) chief executive Levinia Crooks told the Star the perceived shortage of HIV doctors in the inner city had to be put in context.

There is also a shortage of regular GPs who aren’t working in the gay community and who aren’t working in HIV in exactly the same areas, she said.

There were about 145 current s100 prescribers in NSW and the ACT, about 40 percent of whom worked in inner Sydney, Crooks said.

She also said HIV training could be counted towards general GP education requirements.

A NSW Health review published in February said, Support to [s100] prescribers to attend training or participate in other support initiatives is limited.

However a NSW Health spokesperson told the Star the department was working closely with ASHM to boost numbers of s100 prescribers.

Funding to ASHM has been enhanced to strengthen support for existing s100 prescribers and expand recruitment efforts to increase the number of s100 prescribers in NSW, she said.

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