As mentioned previously, practice in remote and rural areas has many financial
disadvantages. In order to recruit and retain doctors in remote and rural
practice these financial issues need to be addressed. This may take the form
of additional payment recognising the higher level of clinical responsibility
and services provided; specific incentive payments for practicing in
underserved areas; financial assistance with accommodation, education and
travel for the doctor and his/her family; and so on.
Another form of material support is the provision of premises and equipment for
the medical practice. Many rural communities provide such facilities to assist
in attracting doctors.
A physician is more likely to remain long term in a rural practice where he or
she is not the sole provider of medical services. Consequently, two or three
doctor group practices are to be encouraged where necessary through direct
financial support so as to sustain the economic viability of the practice. In
order to provide effective primary health care, rural doctors require the
assistance of appropriately trained nurses and other health professionals.
Combining facilities for doctors and other health professionals in rural
community health centres fosters cooperative health care delivery.
After a doctor, the next health service priority for a rural community is a
hospital which provides acute medical, surgical, obstetrics and paediatric
care. Many such hospitals have been constructed and equipped with considerable
financial support from the local community. The hospital is important also to
the economy of the town as a major employer and purchaser of goods and services
within the community. Rural family doctors require facilities and privileges
to provide the needed services for which they are trained and competent. Undue
hardship on rural communities may result from imposition by central regulatory
authorities of excessive certification or fellowship requirements for
performing procedures.
Overall health care delivery may be improved by networking among doctors and
sharing health care facilities and professionals between several communities.
There is a role for government to ensure that the health system provides
appropriate physical facilities and services to meet the needs of rural and
remote communities.