Rural doctors are calling for nurses and allied health professionals to be trained as generalists to tackle the inequality in health outcomes for rural and remote people.
The Rural Doctors Association of Australia (RDAA) said despite government intervention in addressing staffing shortages in country towns, people living in the regional areas still had worse health outcomes than their city counterparts.
“The state of play for rural health across Australia is still one of inequality and equity as far as access to quality health care, but also looking at the health outcomes for rural people,” RDAA president Dr Ewen McPhee said.
“They still lag behind those of people who have greater access to both health professionals and to quality care.
“I think this is still a situation that perpetuates itself in rural Australia.”
Dr McPhee has worked as a GP in Emerald in Central Queensland for more than 25 years.
He said a shift towards training generalist doctors – teaching country students to become jack-of-all-trades country doctors – had helped attract and retain staff.
“We know that when you recruit rural people into healthcare training that you will improve the retention of those people in the bush because they understand the context, they understand the environment and they don’t have that fear … of doing things by themselves,” Dr McPhee said.
“In western Queensland when we’re looking at Longreach, Blackall, Barcaldine and places like that which were traditionally really hard to fill … we actually are seeing some benefits there.
“But we have to really start looking at how we train our nursing professionals and how [we] train our health professionals and what I’m particularly interested in is how we create generalists.
“These [are] people who are able to take all comers, who are able to not just do one little specific part of health care but maybe have two or three levels of expertise.”
Dr McPhee said there was an opportunity to take lessons from the generalist program for doctors and apply them to the shortage of nurses and other medical professionals in rural areas.
“We know that there are tremendous shortages of both nurses and allied health professionals in the bush,” he said.
“Those shortages mean that people have to wait longer, they have to travel further, and they have to expend more of their own resources on seeking health care and often we know that people simply don’t do it.
“They don’t go to the doctor, they don’t see the nurse, they don’t see their allied health professional either because it’s too hard to get there, it’s too expensive or these people simply don’t exist.”
Generalists not a silver bullet
Dr McPhee acknowledged generalists were not a silver bullet, with many of the doctors in rural towns facing incredible workloads, and private rural clinics struggling for long term sustainability.
But he said nothing would change without a shift in thinking at a policy level.
“There’s a disconnect between what government says and what government does, in as much as we’re still talking about money, we’re talking about saving money,” he said.
“We’re not talking about investing in outcomes and it’s time I think that government actually started to look at the outcomes it wants and sets a real strategy that covers everything from the far reaches of the bush right through to the pinnacle of super specialism in the city.
“Do we want hundreds and hundreds and hundreds and hundreds of neurosurgeons or do we want people being able to access the appropriate care, the right people at the right time?”