Rural Health Care

I was lucky to be invited to the “RMA 22” (Rural Medicine Australia) conference in Canberra 10 days ago, the invite came from the Rural Doctors foundation (RDF), they paid all my expenses and organised registration etc. they are a fantastic organisation.  I have put down my perspective from the conference, I’m not saying it is definitive or accurate, these are just my observations.  As those that know me understand I have no formal medical training, my interest in rural healthcare is that it underpins a healthy community, so important.

There was 3 days of presentations from various doctors, students, medical administrators, Government bodies to name a few, the main thread was the passion for rural community health and the different options that communities had to deliver this.  The doctors that I spoke to all loved working in rural and remote areas and their energy and enthusiasm for good outcomes in the community they worked in was infectious.

Listening to the presenters, the theme or culture within the medical sector is that those medical professionals that want to specialise in General Practice, especially in rural Australia, were ostracised by others.  The rural-urban divide is alive and well, no surprises here really, though it is very unfortunate that this sort of bias has been able to thrive.  With the advent of a specialty in medicine of “Rural Generalist”, a GP that has extra skills to be able to deliver good health outcomes in remote regions, normally they would be anesthetists and/or obstetricians as well.  This will hopefully raise the profile and standing, while reducing the bias of these fantastic doctors that we all depend on.

While rural areas have been warning about low GP numbers for a long time, it is starting to become an issue in urban areas, so all of a sudden it is an issue and will take many moons to turn around.  I understand the bias against GP’s in the medical fraternity, most people that enter into medicine are high achievers and so want to reach for the stars and they actively encourage that.  This doesn’t make it OK, to me it says that those that run medical colleges are out of touch with the communities needs and are perhaps too busy making sure that major capital city hospitals are showpieces, they forget about the whole of the country.

The other concerning issue is the lack of respect for skills that rural doctors/nurses attain and that every hospital should have a percentage of their staff with the skills of innovation, making do and ability to connect with the patients.  Our society is multi-cultural as well as having a rainbow of genders that people identify with, they all make up our great community and we all work very hard to make sure that nobody feels left out, rural and remote areas shouldn’t have a bias either.  Organisations such as Australian College of Rural and Remote Medicine (ACRRM) and the RDF are actively supporting and encouraging rural doctors and specialists and have been for 25 years, I hope they receive an increase in recognition and support.

I understand how medical students are attracted to large city hospitals, to aim for the top of their profession and be the best doctor they can be, I never want to discourage that.  From a patients perspective, a doctor that is able to assess the whole body health, draw attention to aspects before they become issues and refer them for follow up if required, they are the heroes.

I remember hearing a presentation from a bloke that left Sydney for a professional job at Condobolin (central west NSW), on the “edge of civilisation” his mates said.  He reckons after being there for a couple of years, he still reckoned he was on the edge of civilisation, he no longer knew which way it was back to civilisation.  He felt so at home and part of a wonderful community he felt a major city couldn’t deliver on the same level, he has never moved back to the city, he has raised a family and retired out in western NSW.  Many of the doctors that I met over the course of the conference I reckon had similar experiences and that was a driver of their passion for improved health outcomes in regional Australia.

There are some rural communities that are “lucky” when it comes to healthcare and others that don’t fare so well.  Like many issues if a community bands together and understands its current healthcare, the communities needs, the resources they have and where they want to get to, they can put some great options to make sure their health is looked after.  A well communicated and reasonable ask from a community to Government is rarely dismissed, this is sometimes forgotten while we blame others for our own situation.  A proposal that clearly explains how a community will acknowledge and respect the health professional, look after their families with childcare, education, jobs for partners etc. and make sure they aren’t overworked, will go a long way towards encouraging great people into your community.