• Volha Pankevich and Christopher Maclain.
• Emergency Department, Albury Base Hospital, Albury, New South Wales, Australia.
• Emerg Med Australas. 2025 Feb 1; 37 (1): e70008e70008.

AbstractThe three-step programme to treat locum addiction locum dependency in rural EDs is a pervasive issue, leading to significant financial strain and impacting clinical care and staff morale. This article outlines a three-step programme to mitigate this dependency. Step one involves government intervention to provide financial incentives for permanent rural doctors and visa regulation for foreign doctors who mandate service in rural communities. Step two suggests that the Australian College for Emergency Medicine (ACEM) mandate rural training for trainees and further integration of nurse practitioners (NPs) into emergency medicine. Step three emphasises the role of individual hospitals in effective recruitment, highlighting the benefits of rural living and the potential of NPs to provide departmental continuity and reduce turnover. These reforms, although independent, collectively aim to enhance the quality of care in rural EDs and optimise resource allocation.© 2025 Australasian College for Emergency Medicine.

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