A WAGGA cardiologist says telehealth is not a replacement for on-the-ground doctors and specialists regardless of increasing pressures on the city's health system.
Professor Gerard Carroll, of Riverina Cardiology, said the local health district will need to discover effective ways to fill current and predicted service gaps as the population pushes towards 100,000 residents.
Although video chat technology has a "great place" in regional healthcare, he said it cannot be mistaken as a suitable substitute for residential specialists.
"It bridges the gap, but it's not a widely accepted solution and not an alternative to good face-to-face care," Professor Carroll said.
"(Specialists) lose a lot over the screen. I want to sit down and be able to see them, examine my patient, read the relationship they have with the people around them. So with the first consultation - and certainly surgical problems - it needs to be face-to-face."
The tyranny of distance has been one of the biggest problems facing regional healthcare, which telehealth had been set up to assist. But the population's growth to 100,000 residents could be more advantageous to the future of Wagga's services, according to Professor Carroll.
"In some ways having 100,000 residents in Wagga will be an advantage, with a centralisation of community health services within the greater population," he said.
"Currently we service a quarter of a million people in an area greater than the size of Tasmania. We cannot provide the same density and number of community health services because that would require a lot of travelling.
"If we have a densely populated group of sick people it will be much easier."
The next step will be addressing the specialist shortages, which can be found right across the board from radiation oncology and geriatrics to urology, rheumatology and some aspects of surgery. He said the top priority will be to recruit specialists who are committed to working and living in Wagga.
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"Even areas that are well served such as orthopedics, cardiology and general surgery - there is an enormous capacity to increase service provision and we are constantly looking for ways to do that," he said.
"Visiting specialists provided extraordinarily good and precious services, but ... we've found the more residential specialists we have, the more service provision infrastructure can be developed around them and the greater capacity to satisfy ... the rural patient's [need] to stay in the bush."
The reality will be that Wagga "will never completely eliminate" the need to travel to metropolitan areas in order to access some health services, Professor Carroll said.
He said there are "extraordinary services" that metropolitan hospitals could provide because of the size of its population.
"The very sticky end of the totem pole that needs really high-end tertiary care such as transplantation, some aspects of neurosurgery - I don't see us in the position to decentralise in the near future," he said.
"It is not reasonable for us to provide these services."
Despite this, Professor Carroll said the city is prepared to cater for a population of 100,000 residents because its current public and private sectors have "a strong backbone" to support growth.