A groundbreaking partnership for local GP clinic Nachiappans is hoping to benefit the entire Broken Hill community, making it easier for anyone in town to see a GP with new bulk-billed Telehealth appointments through the .doctor service.

Principal General Practitioner at Nachiappans, Dr Ramu Nachiappan, identified that GPs have been struggling through the COVID period, forcing him to explore new and innovative ways to address the growing concern for healthcare, especially in regional areas where wait times can exceed three months.

“This is a social project, to be honest. I didn’t look at it from a commercial viewpoint,” Dr Nachiappan told the Barrier Truth.

“I’ve been in town for the last 33 years and I thought at this stage of my career, when I’m heading towards [the] slowing down phase, rather than being dependent on me as an individual, how about creating some sort of network that will support the community? That’s how this came about.”

The organisation Nachiappans has partnered with, .doctor, who will source specialist GPs from around the country and provide them to the practice to help look after the community of Broken Hill. The specialist GPs will conduct their appointments via Telehealth either by phone or video and if there’s doubts that the patients need examinations or assessments, will send them to Nachiappans.


To be bulk billed and follow the rules laid out by Medicare, patients need to have an existing patient relationship with a practice. For current patients of Nachiappans, they can be bulk billed for the next 12 months through the .doctor service in adhering to the existing patient rule, with any in-person appointments that follow also bulk billed.

“We’re following the requirements from Medicare and providing what I’d like to think is very high-quality care from a Telehealth model,” Dr Nachiappan says.

“All of these guys are specialists who provide this as a service to Broken Hill, really. They’re doing this to assist us. They’re bulk billing. They don’t have to. These GPs have agreed to help me and look after the community and essentially the only requirement is that they’re a patient of my practice otherwise we can’t follow this bulk bill requirement that Medicare has put in place.

“Depending on demand, the GPs are happy to extend their hours as well through this .doctor service. They’re all permanent doctors, they’re not locums. Therefore, if someone sees one of these doctors online or [via] Telehealth, they can then ask for the same doctor the next time they want a follow-up so there’s continuity of care, which is a very difficult thing these days in Broken Hill.”

Mr Nachiappan says his practice has gone all out to be accessible to the most vulnerable people in the community; people on lower incomes, people with disabilities, people who can’t afford to see a GP privately, and people who can’t get an appointment. Freeing up presentations to the Emergency Department and helping struggling GPs will bridge the gap, according to Dr Nachiappan.

“I’ve been blown away at how significant the change we can make to the community of Broken Hill,” he says.

“We’re saying don’t leave your GPs. Stick with them. However, this is ancillary, this is backup, this is extra support. To me, it’s a significant potential solution for the community. I’m very keen for us to embrace this model and for people to use this model. All they must do is come on board.”

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