Grampian is facing a family doctor crisis, leaving patients facing long delays for appointments as surgeries struggle to replace a rapidly ageing workforce.
Almost two-thirds of the 503 GPs across the north-east are now working part-time, and an increasing number are nearing retirement.
The problem is most acute in Moray, where 44% of doctors are over-50, with Aberdeenshire and Aberdeen following close behind.
The numbers, highlighted at a summit in the city this week, follow a series of warnings about the impact of medics shortages in hospitals.
Health bosses said more than 90 GPs were due to qualify in the next three years, and it was hoped some of them might help to fill vacancies.
However, delegates at this week’s talks heard patients in the community are already facing longer waits for routine appointments due to spiralling workloads and difficulties recruiting full-time staff.
Concerns were also raised that the high number of looming retirements could soon outstrip the number of new recruits, adding further pressures to a strained primary care service and pushing already overworked doctors to the limit.
Dr Neil MacRitchie, chairman of the Local Medical Committee, which represents about 500 GPs across the north-east, said: “So far GPs and their teams have been able to minimalise the effect of the pressures on patient care.
“They are doing this by working harder and working longer hours, but there will be a limit as to how much further this can be pushed.
“Some patients will already be finding they are having to wait longer for a routine appointment.”
This week’s workforce summit, involving GPs and NHS Grampian, follows a major piece of research by the north-east board into staffing issues.
All 80 surgeries across the region were invited to take part and gave an unprecedented 100% response rate.
Figures showed there were 503 GPs in Grampian this year, up from 471 the year before.
However, doctors’ leaders said the numbers did not highlight the high proportion of part-time or aging medical staff now in the area.
In Aberdeen, 62% work part-time hours, as do 60% in Aberdeenshire and 61% in Moray.
The proportion of medical staff who are over-50 is highest in Moray at 44% with 35% in Aberdeenshire and 28% in the city.
Practices reported vacancies going unfilled for six months or more, with some generating no interest at all.
Dr Ken Lawton, provost of the north east Scotland faculty of the Royal College of General Practitioners, said: “Some say there are enough GPs in training to replace the GPs retiring, but the issue is that not all those who train in Grampian stay in Grampian.
“Not everybody who trains full-time will work full-time. Increasing numbers of doctors don’t work full-time. Those working five days a week have become a vanishing breed.”
He said one practice in Buchan had been unable to fill a permanent post for more than a year.
Locum cover has been equally hard to secure in some cases, he added.
A spokesman for NHS Grampian said: “This 2013 version is the third survey we have carried out and used as a workforce planning tool to support GP practices.
“Working in collaboration with our GP colleagues in this way allows us to identify both workforce supply and demand for the future. For example, over 90 GPs will qualify in the next three years which will help fill the slots of GPs planning to retire.”
A Scottish Government spokeswoman said: “The Scottish Government continues to support, build upon and sustain Scottish general practice.
“Investment in primary care has seen the number of GPs increase by 5.7% under this government and there are now more GPs per head of population in Scotland than England.
“A new £40 million primary care development fund, announced last week, will ensure our GPs and primary care professionals can help our health service evolve to meet the changing needs of the people of Scotland.
“The Scottish Government has invested £50 million in primary care and community premises across Scotland this year. This is additional to the £250 million investment in community based health facilities through the Hub programme.
“Further investment of £19 million in primary care projects in Grampian was also announced last week as part of a multi-million-pound package to fund new hospitals and health centres round the country.”