Rural Round-up : October 13

This month's rural round-up is written by the secretary of the WONCA Working Party on Rural Practice, A/Prof Bruce Chater of Australia. Find out more about his perspectives and about life as a GP in Queensland.

I am a rural general practitioner and work in a small town 250km from the nearest specialist. I have been a member of the Wonca WP since 1995 and have seen the Wonca Working Party on Rural Practice develop over that time to embrace the needs of the developed and developing world. Our first conference was in Shanghai and in a rural area outside the metropolis in 1996. The thing that struck me at that first conference and since, is that all rural doctor have the similar issues – just different flavours. These issues and suggested solutions were captured in our Policy on Rural Practice and Rural Health- 2nd edition 2001.

Much is often made of the poorer health status and standard of living in rural areas – this is true and desperately so in some places but with the provision of public health, good generalist health care and extra job opportunities, rural areas can be wonderful places to live. Rural doctors can be part of the required change to enhance that.

I live in a rural area in Queensland in Australia. If the State of Queensland was a country, it would rank as the 25th largest in the world. The distances are vast, often with hundreds of km between health facilities. I was recently asked by the Health Minister to develop a plan to better utilise Queensland’s rural health services. The basis of the report is that public need to know what to expect of its services, that generalist doctors and nurses need to be trained and enabled to staff these facilities and general practices and that they should be supported to provide a wider range of services such as birthing and chemotherapy, where appropriate, supported by outreach telehealth. The Minister has accepted the plan and we are in the middle of implementing it. (Download plan)

A key element of this is the role of the rural general practitioner that is best suited to the geographic dispersion that characterises Queensland (and many dispersed areas around the world). The recent Health Workforce Australia review outlined this role as rural medical generalists who have skills to:

• Provide unsupervised, un-referred community or primary care of individuals, families and communities
• Work unsupervised to provide in-patient and emergency care in a hospital or related setting such as a remote health centre or multipurpose health service
• Provide extended specialised service in at least one approved medical discipline required to sustain comprehensive health care services in regional, rural and remote communities
• Provide services across the continuum of care in a range of settings and service delivery models including outreach where required
• Apply a population health approach with relevance to the community in which they practice.

This is of international interest and will be the subject of a Summit in Cairns Australia in late October hosted by the Australian College of Rural and Remote Medicine (ACRRM) and supported by the Wonca Working Party on Rural Practice (WWRP).

The final project of the working party that I would like to mention is the Guidebook on Rural Medical Education which is on track for web based publication next year. We have received over 60 chapters about a wide variety of rural medical education subjects and hope that these practical examples will build on and help those of you who seek to implement our policies on rural education and practice.

Rural and urban general practitioners have much in common with and a proud shared tradition. The solutions to providing health care will vary around the world. As one of my colleagues is prone to say "when you have seen one rural town you have seen one rural town” - we look forward to our efforts resulting in healthier people leading happier lives in those towns and villages.

Assoc Prof Bruce Chater
Secretary WWPRP

Find out more about the WONCA Working Party on Rural Practice