Life on Kangaroo Island as a general practitioner can be extremely rewarding.
Doctors at the KI Medical Clinic are however finding negotiations with state health authorities far less fruitful.
And finding new doctors to live on the Island is proving equally challenging.
With two more of the clinic's doctors finishing up this year, the Island could potentially be left with only one local doctor while visiting locums filled the gaps at the clinic and hospital.
The Barossa Hills Fleurieu Local Health Network says it's committed to recruiting more rural generalists to serve its rural communities, including KI.
But the KI doctors say the reality is it could take up to three years to fill the positions left vacant on the Island.
Doctor Johannes Steyn is about to retire and said the Island had lost multiple long-standing local doctors over the last four years.
The clinic contract with the local health network expired back in November and had not been renewed.
Negotiations continued, particularly around the arrangements for the doctors' duties at the hospital, he said.
Insufficient resources were being made available to keep the system going and the health system was too focussed on metropolitan Adelaide, he said.
The fact that young people coming into the health industry were now more interested in specialist fields was also making it harder to keep the rural system going.
Medicine in country areas had suffered as a consequence.
"This is a problem not just for the doctors," he said. "We're battling for all the medical workforce on the Island in rural areas.
"That includes the nurses at the hospital, our nurses and staff at the practice, physiotherapist and mental health practitioners."
The Islander has also spoke with the secretary of the Australian Nursing and Midwifery Federation SA about the situation for KI nurses and we will be filling a follow-up report.