New Zealand is facing a doctor shortage crisis as the country continues to haemorrhage locally trained physicians in large numbers to more lucrative jobs overseas, the Association of Salaried Medical Specialists (ASMS) says.

It was a "pretty parlous state" and unsustainable, said ASMS executive director Ian Powell, who warned measures to address the problem were "only playing around the margins".

Twenty-nine percent of New Zealand doctors are working overseas and about 40 percent of doctors practising here have been trained elsewhere, the highest percentage in the Organisation for Economic Co-operation and Development (OECD), followed by Australia, at between 15 to 20 percent, which continues to attract many of our doctors.

The shortage was putting pressure on the existing pool, increasing the workload of those specialists remaining, forcing them to retire earlier and making it less attractive to work here, Mr Powell said.

"It's an ever-decreasing vicious circle. We are basically trapped in a vice and it requires a significant quantum leap to get out.

"We are not going to be able to make the quantum steps we need until we actually have salaries that are sufficient to keep the doctors we train."

Specialists starting out in Australia could earn a salary comparable with someone with 15 years' experience here, he said.

It was expensive to recruit internationally. Overseas-trained specialists did help but that was expensive because training systems differed, he said.

Also, a significant number that were recruited here left after two or three years.

Mr Powell said the ASMS was working on a joint business case with district health boards on the issue, which would also go to government to hopefully provide the basis for the "circuit breaker".

In August the ASMS released a paper which showed that in 2008 the specialist workforce shortfall was more than 600 specialists, based on international benchmarks, and another 1300 specialists were needed to equal Australia on a population-adjusted basis.

Meanwhile, medical clinics are paying thousands of dollars each to advertise overseas to fill vacancies.

Mark Peterson, chairman of the Medical Association's GP council, said there were long-term GP shortages on the Kapiti Coast, in the Hutt Valley and Levin, where 2000 people were unable to register with a doctor.

Dr Peterson said he was surprised that doctors could not be persuaded to live and work on the Kapiti Coast. "Then I suspect there are significant problems elsewhere. Most provincial centres and rural areas are short of GPs," he said.

"Many of those provincial centres are at tipping point."

Advertising for doctors overseas was not working, he said.

"Not only are we spending lots of money advertising overseas ... they are spending lots of money in New Zealand attracting our doctors overseas."

Australian groups were cold-calling doctors here and offering them $400,000 to $500,000 in capital for a 10-year "golden handcuffs" period. "We can't compete with that sort of money."

Terms and conditions were also a problem, he said. For self-employed GPs it was hard to standardise conditions nationwide and doctors considering coming here were put off not only by the money but also the after-hours work, contact hours, time for paperwork and time to study.

There were not enough training facilities to train 100 new doctors a year to address the estimated shortage of 1000 GPs and it took up to eight years to train a doctor.

The average age of GPs was about 50 and there was a significant number in their late 50s-early 60s who were looking to retire in next five to 10 years,

Dr Peterson said the Government was trying to address the problem

"It does need drastic action. They [the Government] are probably not doing as much as is necessary. They might be doing all they can but it's a little less than is necessary."

(Source Otago Daily Times)