Dr Kiran Puttappa was appointed President of the Australian Indian Medical Association (WA) in August last year.
After completing his medical training in India, Dr Puttappa worked in various hospitals in the UK before moving to Australia and settling in Perth in 2004.
After initially training in Psychiatry in India and the UK, Dr Puttappa undertook his physician training while he was a registrar at Sir Charles Gairdner Hospital. He completed his training in 2010 and opened his first general practice, Okley Medical Centre, in 2011.
Now, 14 years later, Dr Puttappa is the chief executive and founder of GP West with 20 medical centres across Perth. He is also a WA council member of the Royal Australian College of GPs.
Medical Forum spoke with Dr Puttappa about his aspirations for AIMA-WA and his experience as an internationally trained doctor.
MF: You have had a successful career as a GP – you founded GP West, and you are now president of AIMA-WA. How did you get to where you are now?
KP: I came here from the UK for one year, my plan was to go back, but I never went back. I liked it here, the culture, the medical system and, of course, the weather. The weather here is similar to where I grew up in India, so in that way everything was perfect.
Being a GP is a good lifestyle and has flexibility. In the hospital I was a cardio registrar and a neuro registrar, so whole nights I could be on call, and the next morning.
But primary care is close to the heart. You feel very close to your patients and that’s very important, it’s not only the flexibility for my personal life but from a patient perspective you become part of their family in a way.
I have around 20 GP clinics now. Okley is my first medical centre, it’s close to my heart and that’s the reason why I still work there. My second is Ellenbrook and was started in 2014. The reason I started it was because I had a few doctors approach me looking for a job, but we did not have any spots.
I had got to understand the art of running a business, so, I thought, why not open a second? And then a second became a third, a third a fourth and so on.
MF: You have been in Perth 20 years now, how has the medical system changed in that time and what are some of the challenges you’ve faced along the way?
KP: General practice is becoming tougher and tougher every day. There is the rising cost, doctor shortages and, of course, Medicare rebates are not enough.
General practice is a specialty just like any other, but if you compare the Medicare rebates with non-GP specialists and to us, there’s a significant difference.
General practices are shutting down recently, they cannot survive. If you have one GP or two GPs in a practice you need to have a practice manager, you need a nurse, you need to pay the rent…how can you afford to run the business?
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COVID dramatically changed general practice. Up until then we had never heard of teleconsultations, but they started during COVID and are still ongoing. There are a lot of private platforms now for telehealth consultations that are non-Medicare. It’s good for the patients but at the same time I would say it’s making things more fragmented.
Coupled with the bureaucracy of the pharmacy prescribing and all of those things, the care of the patient is getting fragmented. It impacts quality of care, that’s where we are at the moment.
MF: What do you hope to achieve in your two years as president of AIMA-WA and how does the association support international medical graduates (IMGs)?
KP: We are the strongest Indian medical association here in WA. We have around 650 doctors registered in Perth and the outer metro area.
We run a lot of health awareness programs, we support medical students and have an IMG support group so they have someone to help them to settle into the Australian medical system more effectively and easily.
It’s not just Indian doctors – we work with any IMG. Any doctor can join our organisation as long as they believe in the constitution of AIMA-WA – we have a lot of British GPs who are members of AIMA-WA.
We also do a lot of charity programs. During COVID we raised $150,000 and donated it to the Red Cross, Destiny Rescue, Perth Children’s Hospital and a number of other organisations. We have a big gala event every year and the funds raised go to charities.
During my time as president, I would really like AIMA-WA to be involved in advocacy and government decision making in health, we want to be a main stakeholder just like the AMA.
We have experienced doctors starting from consultants right through to head of departments and directors of training, and they could use the expertise of the association on policy changes. If you can get the medical profession involved [in decision making] then it will reach the public and culturally diverse communities more effectively.
At the end of the day, when the government makes a decision about health it has to be realistic, and it should reach all patients in the right way. If patient care is considered in policy making, then that’s good for the community.
MF: India is one of our biggest sources of OTDs and we are expecting to see more international doctors working in Australia through the Australian Health Practitioner Regulation Agency’s new expedited pathway. What is it like moving here as an OTD?
KP: Any doctor coming to a country like Australia needs to be well supported, irrespective of which country they are coming from. If they feel like they’ve been left alone and are not part of the system, they cannot work effectively.
They may have the skills, but if they’re not supported it will be difficult for any practitioner coming from overseas to deliver quality care. They may end up leaving [the profession] depending on their personal circumstances.
That’s when they seek help from professional organisations like AIMA-WA to see if we can help them out.
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MF: Are there any challenges that OTDs face working in WA?
KP: The Distribution Priority Area (DPA) is hampering our efforts to recruit more GPs. We may have GPs wanting to come to WA, but we only have very limited places where they can work.
I could have a GP call me tomorrow and say they want to work at Okley Medical, but I can’t take them because it’s not a priority area. They can only work in a DPA location for 10 years. It’s a big commitment for an international medical graduate.
MF: Do OTDs experience much racism and discrimination when they move here?
KP: Personally, I haven’t had any racist experiences in my medical career, whether that was in the hospital systems or as a GP.
There are instances that happen all over the world, but Australia is a great system and colleagues have been supportive.
The international medical graduates who have come here and settled are quite happy. But we do get phone calls about it at AIMA-WA, that’s why we have the IMG support group. We also run a program for medical students to support them during their training.
If IMGs decide to come to Australia, they are definitely more than welcome.
MF: A recent Federal Government supply-and-demand study suggested GP shortages in Australia will increase from 800 in 2024 to 2600 by 2028 and 8600 by 2048. To help plug gaps we have increasing numbers of OTDs in the system, but this has been a point of contention and concerns have been raised about international graduates taking limited training spots from ‘homegrown’ doctors. What is your response to these concerns?
KP: The government should be looking into promoting local doctors as a priority. They need to provide more funding for education, more funding for primary care and they need to make primary care attractive.
Good funding for general practice, so GPs can provide quality care, is hugely important. The more money that’s put into primary care, you’re actually saving money.
But, of course, we need to look to international medical graduates. There should be a correct selection process and good support systems in place. If IMGs are coming in and are seen on par with the local trainees, they apply for jobs and are treated equally, that’s fair. But if one is treated inferiorly or superiorly then that’s not correct.
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MF: Concerns have also been raised about Australia’s impact on international medical systems through overseas recruitment, do you share the same concerns?
KP: I agree with that, but it also comes down to the doctor’s personal choice.
Every country needs to improve their health system so they can keep their homegrown doctors in their own country. I don’t want the same thing to happen to Australia where the homegrown doctors start moving to different countries because they’re not well supported.
If you don’t look after the IMGs as well, then they may choose to go to different countries, so the Australian healthcare system will definitely be affected.
In the UK, even though the NHS is fully aware a lot of UK doctors are moving to Australia, they haven’t taken effective steps to keep their homegrown doctors.
MF: What advice do you have for GPs looking to set up their own medical centre?
KP: Do your due diligence well before you set it up, because at the end of the day you don’t want to be shutting down your practice one or two years later.
Look at who you need to hire. Allied health is so important and without a practice manager you can’t run a practice.
My first practice was a bit difficult. I had to learn the art of running a business. Now I’ve got a very good team who can set them up and run them, so that’s very important.
As a new GP, setting up a clinic in the current situation is very tough. But if you can do your due diligence and provide a good service, then why not go for it?
ED: At the 2024 AIMA-WA gala dinner the State Government announced that 150 trainee doctors from India would arrive to work in WA under a new program starting in January 2025. Neither the AIMA-WA or AMA(WA) were consulted on the program. AMA(WA) has raised concerns about the lack of detail on where the doctors would be working and how they would be supported in the system.
A State Government spokesperson said from January 2025, Indian trained medical graduates, who have successfully completed the AMC1 examination are now able to apply to work in WA Health.
“As with all recruitment pools, offers of employment are subject to public sector standards and are a highly competitive process,” they said.
“Future opportunities to support up to 150 Indian trained medical graduates, with relevant clinical experience, is expected to be finalised in early 2025. The AMA and AIMA-WA will be consulted once finalised.”
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