Guest Column
As a semi-urban GP who enjoys working rurally, I think I have gained an objective view of rural medicine issues – initially via locum stints and now through sessions in the Wheatbelt. Changes in models of rural care have increased patient and community expectations of general practice. As demands on shrinking general and procedural GP services increase, demands for specialist services also increase. Technology such as eHealth, TeleHealth and ETS helps with supply but it is by no means solving the service shortage.
There is a growing number and complexity of patients in rural areas needing both chronic and appropriate acute primary care. As a result, these patients are being inappropriately diverted to rural ED settings. This complicates the issues of hospital and RFDS transfers, rural hospital inpatient care and delayed access to primary care. All add to the cost of health provision.
The current solution involves increasing
Protecting an Endangered Species
Dr Will Thornton says rural GPs need serious support before they become a thing of the past.
the level of ED staffing with FACEM-led ETS access to city services, which has some benefits but it needs to integrate with the existing primary care service providers.
The usual solution to the shortage of GP service is to import it – and obviously overseas trained doctors( I am one too!) play a vital role. But for a sustained long-term solution, local graduates need training in rural medicine. WAGPET, our regional training provider, is excellent but no longer are all their Registrars required to complete a rural term, and the assessment for entry reflects this. Yet country hospitals and general practice in the Wheatbelt offer amazing educational opportunities.
Workforce provision is challenging; but local networks often have fiscal interests that outweigh the practical need of the community for continuity of care by a regular provider.
University courses are under fiscal pressure to reduce / rationalise the rural component of their courses, often pressured by the bureaucrats but also by content-driven and assessment-pressured students.
So, how to retain existing services and attract the new?
What may work:
�� ��������������������������������������������( such as the Rural Incentive Program)
�� ����������������������������������
�� ����������������������������������� � remuneration for rural GPs.
What won’ t work: �� ������������������������������������
�� ������������������������������������������� specialist-led services.
Retention is paramount and that involves looking after GPs who have served their community, 24 / 7, for years.
Rather than ignoring burn-out, we need to look at providing some respite( a model embraced by one Wheatbelt shire, where the local GP gets a five-day weekend every six weeks), on-call cover such as ETS, assistance with ongoing education, finances and sessional cover. Why don’ t Country Health Services provide performance reviews such as those encompassed in revalidation, rather than vilification and medical board referral?
Without these issues being addressed, the rare rural GP will be a thing of the past. �
Interested in becoming an Approved Medical Specialist in the workers’ compensation system?
Train with a world-renowned expert in Permanent Impairment and Occupational Medicine
WorkCover WA is pleased to announce that international expert ert in occupational medicine, Professor Mohammed Ranavaya, will be in Perth on 27 and 28 July to conduct training and workshops in the AMA Guides 5th Edition. This is a rare opportunity for medical professionals in WA to train with a recognised authority in the use of the AMA guides.
Day 1 of the program will review the concepts and methodology of AMA 5, including relevant case studies. The morning of Day 2 will consist of chapters 5 – 13 of AMA 5, along with discussions on the central and peripheral nervous system, mental health and behavioural disorders.
The second part of Day 2 will entail an examination that will qualify medical ��������������������������������������������������������������������� ������������������������������������������������������������������������������ �������������������������������������������������������������� www. abime. org.
1300 794 744 | www. workcover. wa. com. au
�����������������������������������
����������� play an important role in the Western Australian workers’ compensation system by conducting impairment assessments sessmen that determine whether injured workers are eligible to access ���������������������������������� law claim for damages.
Training in the use of the American Medical Association Guides to the ������������������������������������ �������������������������������������� towards gaining your accreditation as an AMS.
All medical practitioners are welcome to apply. WorkCover WA is particularly interested in applications from specialists practicing in areas of occupational and environmental medicine, orthopaedic surgery and plastic surgery and / or who are located in regional areas.
26 medicalforum