Armed standoff at GP clinic: four escape as police shoot gunman

Heavily armed police were called to the medical centre on Junction Street in Nowra just before 1pm on January 10 after receiving reports that a patient had produced a gun.

Assistant commissioner Peter Cotter said he was "known to the centre and to medical staff that worked there".

The 34-year-old man allegedly pulled the gun after an "agitated" dispute with his doctor.

All four people in the clinic were "able to make their escape from inside the doctor's surgery which left the gunman alone" before he was shot, assistant commissioner Cotter said.

Police said the man was allegedly armed with a semi-automatic pistol when he came out of the clinic and "confronted officers" at 2.40pm.

A police ballistic shield that had been dropped during "the initial confrontation" was picked up by the alleged gunman, assistant commissioner Cotter said.

"A number of shots" were then fired by police, he said.

He received treatment NSW Ambulance paramedics but died at the scene, police said.

The man has not been formally identified but was known to police due to a "very, very minor criminal record" and was known to have mental health struggles.

Police said the case will be independently reviewed by the Law Enforcement Conduct Commission and a brief will be prepared for the Coroner of New South Wales.