“Change is happening, and the long-term outlook is improving”, Dr Bill Geyer, SA Rural SLO

Dive into an inspiring read from Dr. Bill Geyer, the RACGP’s SA Rural SLO and President of the Rural Doctors' Association of South Australia (RDASA). Our Communications Manager, Pauline Ingham, sat down with Bill to learn more about his journey, his passion for rural healthcare, and his dedication to championing change and shaping a brighter future for rural general practice.

Could you share your journey into your current role as an SLO? What inspired or motivated this path for you?

"My journey into the SLO role was far from glamorous—it actually happened by accident. I initially got involved in registrar supervision because I felt a strong obligation to contribute to training the next generation of GPs. Our practice hadn’t supervised registrars before, so it was a new venture. After discussions with my partners to get them on board, we began supervising, which I believe is essential for staying accountable and current. Teaching requires us to maintain our knowledge and find effective ways to pass it on.

"As for becoming an SLO, that was another unexpected turn. I was “tapped on the shoulder” by Dr. Paul Delina during my time at GPEX. Now I am fortunate to work alongside Dr. Frank Maldari, current Deputy Chair on the GPSA Board and urban SA SLO, who’s been an incredible mentor. His expertise in supervision, medical politics, and broader issues in the field has been invaluable to my development.

When I was approached for the SLO position, I felt flattered and recognized the importance of the role. It’s an opportunity to address challenges in general practice and supervision, and I saw it as a chance to make a meaningful contribution to the field.

How have your various roles prepared you for your work as an SLO?

"My answer might surprise you, but one of the key ways my experiences have prepared me is through my love of travel and exploring South Australia. Over the years, my two sons and I have taken countless camping trips to almost every corner of the state. This familiarity with rural South Australia has given me an appreciation for the challenges faced by country practices and the importance of connecting with them personally.

"As an SLO, I’ve made it a priority to visit practices in person whenever possible. I often combine these trips with external clinical teacher visits (ECTVs) to registrars, targeting areas I haven’t yet been to. Meeting supervisors and registrars in their own practices is invaluable—it provides a deeper understanding of their unique circumstances, far beyond what can be gained at networking events in Adelaide.

"Another experience that’s been instrumental is my role as President of the Rural Doctors Association of South Australia. This position has allowed me to engage with rural doctors, policymakers, and leaders in the health department. It’s given me insights into the broader issues faced by country doctors, particularly the “tyranny of distance” and the challenges of delivering healthcare in remote areas.

These experiences have fueled my passion for rural general practice in South Australia and my commitment to making a difference.

"That said, I’ve learned that not every problem has a quick fix—whether it’s in supervision or broader healthcare. Some challenges are systemic and require collective effort. Organisations like GPSA play a critical role in addressing these bigger-picture issues, which we’ll delve into with your other questions."

What specific skills or insights that have been particularly helpful with your SLO role?

"Having a solid understanding of governance and how committees operate has been incredibly beneficial in my SLO role. It’s not just about attending meetings but about coming prepared—doing the pre-reading and fully engaging with the material

Simply showing up and winging it doesn’t work, especially when important decisions are at stake.

"Another key skill is persistence in following up on issues. When challenges are identified, I make it a priority to address them, even though solutions aren’t always straightforward. While not every issue can be resolved, I believe in doing everything possible to work towards a resolution. That commitment to seeing things through has been a guiding principle in this role."

How does GPSA factor into your SLO role?

Through advocacy work, top-notch educational materials and opportunities for supervisors to engage in research and collaborative projects.

"One of the key contributions of GPSA is its advocacy work. At our recent SLO meeting in Brisbane, for instance, we had the heads of RACGP and ACRRM sitting with experienced supervisors discussing pressing issues in general practice supervision. Having direct access to decision-makers and representing supervisors' concerns is vital.

"Another crucial advocacy role GPSA fulfils is negotiating the National Terms and Conditions for Employment of Registrars (NTCER). It’s essential that supervisors have a dedicated body representing their interests in these discussions. If this responsibility were left solely to colleges or other organisations, there would be a significant conflict of interest—it’s critical that supervisors themselves, alongside registrars, have a voice in shaping the terms of employment.

"GPSA excels in providing top-notch educational materials for supervisors and registrars. The teaching plans are incredibly well-structured, offering scenarios, Key Features Problem (KFP)-style questions, and references, which make preparing for registrar teaching sessions much easier. For example, if a registrar wants to discuss atrial fibrillation, you can refer to GPSA’s ready-made teaching plans.

"In addition to the teaching plans, GPSA offers an extensive library of podcasts and webinars, which are invaluable for ongoing learning. Even if you can’t attend a webinar live, the recordings are accessible anytime, allowing you to revisit key topics as needed. Considering GPSA’s relatively small team, their ability to produce such high-quality resources is remarkable.

"GPSA also provides unique opportunities for supervisors to engage in research and collaborative projects. For example, I was recently invited to participate in a project exploring gender dynamics among supervisors. While these opportunities might not appeal to everyone, they demonstrate GPSA’s role in fostering professional development and addressing diverse issues in supervision."

What aspect of GPSA’s work do you personally value the most?

I think one of the most important aspects of GPSA’s work is ensuring that supervisors aren’t taken for granted.

"There’s often an assumption from those in control that Australia’s general practice training program is thriving because it consistently produces fantastic GPs—and that supervisors are doing such a great job, they’ll just continue to deliver without much support or recognition. But that’s not sustainable. GPSA’s advocacy is crucial in reminding decision-makers in Canberra and the colleges that supervisors play a pivotal role and need proper representation. For me, that advocacy and representation are invaluable.

"An aspect I particularly appreciate about the Supervisor Liaison Officer (SLO) role is the collegiality. The SLO Advisory Council, which meets annually in a capital city, is an incredible opportunity to connect with other senior supervisors and stakeholders. Hearing first-hand about issues faced in other states is enlightening—it reinforces that many challenges, like the transition to the single employer model, are shared nationally. For example, during recent SLOAC meetings in Sydney and Brisbane, we discussed some of the concerns and uncertainties around this new model, identifying strategies to navigate its introduction.

"This dual dynamic of internal networking and external advocacy is what makes GPSA’s work so valuable. It strengthens the supervisor community while ensuring our voice is heard at the highest levels."

In your view, what are some of the biggest challenges facing supervisors today? 

"One of the biggest challenges for supervisors is the feeling of being taken for granted. A clear example is the Early Assessment of Safety for Early Learning (EASEL). While it’s a fantastic initiative to ensure registrars are practising safely, it places additional demands on supervisors without compensation.

"Conducting EASEL involves reviewing a registrar’s consultations daily, providing guidance on patient management, clinic systems, and workflows. It’s invaluable for identifying safety concerns and enhancing registrar learning, but it comes at a cost. Blocking out appointments in an already overwhelmed environment affects both the supervisor and the practice.

"This highlights the need for stronger advocacy, such as an item number for supervision. Supervisors face increasing demands to train registrars, maintain patient care, and adapt to new systems without adequate support.

On a brighter note, registrar shortages appear to be improving. For the first time in nearly a decade, Semester 1 training places for 2025 are fully subscribed for RACGP, with ACRRM oversubscribed—an encouraging sign for general practice.

Are there any specific challenges for rural GPs / RGs?

"A key challenge facing country general practice, particularly in South Australia and likely across other states, is the issue of after-hours care. In smaller centres with local hospitals staffed by GPs, the burden often falls on us to work all day in the clinic, remain on call overnight, and then back to work the next day. It’s a system that many of us have endured for decades, but it’s increasingly clear that this approach isn’t sustainable—nor is it attractive to the next generation of doctors.

"With the introduction of safe working hours provisions in the National Terms and Conditions for General Practice Training from next year, this reality is hitting home. These safeguards, long established in teaching hospitals, are now extending to registrar training in general practice. It’s a necessary shift, as we can’t expect registrars—who’ve trained in hospital environments where such demands are unthinkable—to suddenly adopt outdated work patterns."

The challenge lies in adapting.

"While some fear this could spell the end of country general practice, I don’t believe it has to. The solutions will need to be region-specific, but with thoughtful planning, open communication with registrars, and adjustments to practice systems, we can find a way forward.

"By addressing after-hours demands proactively, we can not only ensure continued care for our rural communities but also create a better quality of life for everyone involved—starting with our registrars."

What message would you like to give supervisors?

"My message to supervisors is: hold your course! The efforts to strengthen the general practice pipeline are starting to show results. I’m speaking primarily from a rural perspective, as that’s my focus, but the impact is becoming evident.

"In our practice, we’ve hosted medical students for years. However, the familiar pattern was that they’d head off to the cities as junior doctors and often never return. Negative influences from other health professionals - comments like, “Why would you want to be a GP? You’d be better off as an anaesthetist or a dermatologist” - often discouraged them from considering general practice. For many, that was the last we’d see of them.

"Now, with changes in place, we’re starting to keep them connected through their internship and junior years. Programs like South Australia’s ‘Road to Rural’—run by the Rural Doctors Workforce Agency—are making a difference. By placing interns in country practices, they’re getting exposure to both general practice and rural healthcare, which is something we’ve needed for a long time. It’s reminiscent of the old PGPPP program, though we can’t call it that!

"Beyond internships, postgraduate year two (PGY2) registrars and residents are being placed in rural hospitals and practices, further embedding them into our communities. This supply of registrars is a lifeline for practices like ours, as workloads continue to grow.

So, to my fellow supervisors: hang in there if you possibly can. It feels like the Titanic is finally starting to steer away from the iceberg. Change is happening, and the long-term outlook is improving.