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Attention doctorportal newsletter subscribers,

After December 2018, we will be moving elements from the doctorportal newsletter to MJA InSight newsletter and rebranding it to Insight+. If you’d like to continue to receive a newsletter covering the latest on research and perspectives in the medical industry, please subscribe to the Insight+ newsletter here.

As of January 2019, we will no longer be sending out the doctorportal email newsletter. The final issue of this newsletter will be distributed on 13 December 2018. Articles from this issue will be available to view online until 31 December 2018.

The bush GP: what it’s really like working in a remote location

 

Being a GP in a remote outback location is rewarding work – but it’s not necessarily for the fainthearted. You’re likely to be the only doctor there, and if things go wrong, help may be some time coming.

“You’re by yourself, you’re thrown in the deep end and you’ve got to manage that,” says Dr Chris Clohesy (pictured), who has spent the last five years working as a GP in remote communities in Northern Territory, after a 20-year career in the city. “There’s the constant threat that something will come up that takes you to the limit and there’s no one holding your hand. You’re asking yourself: am I up to it?”

Dr Clohesy recounts a time when he had to manage a child who had drunk petrol and was fitting.

“I was in a remote community and there was only me and a couple of nurses. We didn’t have much equipment and we were talking to Darwin by phone, with a plane a good couple of hours away. This one had a good outcome, but you remember these things. They’re frightening and challenging situations.”

And then there are the more quirky episodes that a doctor is never going to experience in a suburban Sydney clinic – such as the occasional veterinary intervention, for example.

“Late one day a chap brought in his dog, which had been run over and had a massive abdominal wound, extending from the groin to the belly. Can you do anything, the owner asked. So we sewed the dog up and gave it some antibiotics and incredibly, the dog survived. I couldn’t believe it! So you do have to think out of the square and handle some weird cases.”

The key to working remote, Dr Clohesy says, is to keep your skills and knowledge up to scratch.

“It’s a difficult process finding the educational resources to be able to upskill. I spend a lot of time hunting down courses and clinical attachments to keep me up to date. And it’s a lot of time and money. Rural and remote doctors have the same educational requirements as everyone else, but it’s a lot harder to get them. And for junior registrars studying for exams it’s really hard, particularly if you have a dodgy internet connection!”

Online learning definitely has a big role to play for rural and remote doctors, Dr Clohesy says.

“But it’s got to be good. You can’t just put something up on the internet and say, there you go. There’s still got to be some sort of human contact with that online course where you can actually talk to someone, and an expert you can contact really enhances the course.”

Dr Clohesy recently flew to Melbourne to do an Advanced Life Support course. He says he paid his own airfare, plus the $700 for the course, with the whole trip taking three days.

“That’s so I’m up to speed on the cardiac stuff I need to deal with out here. It’s not about sitting about under a palm tree on the beach; it’s a serious challenge.”

And it’s also important to keep your outside interests and lifestyle ticking over, Dr Clohesy says, whether it’s sport, exercise, fishing or reading.

“At the moment I’m getting my bikes and gym equipment shipped to me by barge from Darwin. Luckily, where I am has a swimming pool, so I can do my laps which is important to me.”

Keeping in the medical loop and maintaining your networks is also important when you’re working in remote locations.

“I belong to the AMA, I join as many committees as possible, and all that improves my interactions with other doctors.”

The job definitely has its own rewards, Dr Clohesy says.

“Most doctors are out here because they want to help, and they want to look after these impoverished people, and that gives them a huge amount of satisfaction.”

Junior doctors may think if they go rural they’ll miss out on positions in metropolitan hospitals, but that’s not at all the case, Dr Clohesy says.

“These days, as a junior doctor, it’s really positive to have a CV with some rural work on it. It shows you can work independently.”

And there are various incentives, such as the General Practice Rural Incentives Program, which pays doctors an annual amount for working in rural and remote areas, with the amount rising with each extra year of service.

“We have a public health role. I think it would be great if all doctors did a six-month stint in a rural or remote community. We’d overcome a lot of deficiencies if that happened.”

  • Are you working in a remote or rural community? Doctorportal Learning has a number of online learning modules that may suit your certification needs.
  • Our Cranaplus Advanced Life Support Certification can be completed entirely remotely, with an online theory component and a clinical assessment using Skype. This module is the only accredited ALS in Australia that enables you to undertake the clinical assessment via a virtual platform.

 

Rural conference focuses on doctors’ health and training pathways

 

The peak national event for rural doctors is set to kick off next week in the distinctly unrural Melbourne, with a stellar line-up of presenters.

Among the speakers at Rural Medicine Australia 2017 are former Greens leader Dr Bob Brown; Dr David Gillespie, Assistant Minister for Health; and Shadow Minister for Health Catherine King.

The event will include a Presidents’ Breakfast forum facilitated by distinguished medical broadcaster Dr Norman Swan, with a panel including RAGCP President Dr Bastien Seidel and the AMA’s Vice President Dr Tony Bartone, along with Associate Professor Ruth Stewart, President of the Australian College of Rural and Remote Medicine (ACRRM).

Forum host Dr Ewen McPhee, President of the Rural Doctors Association of Australia (RDAA), says the forum will cover a range of issues, including the poor distribution of doctors between urban and rural areas, as well as political initiatives such as the implementation of a National Rural Generalist Pathway.

“Key government and opposition members will be in attendance at the breakfast and we’ll be having discussions around medicopolitical issues, but also the broader issues of Medicare and the Medicare rebate, as well as the codeine prescription issue,” Dr McPhee told Doctorportal.

Dr McPhee said some of the key themes of the conferences would be doctors’ mental health.

“This is an issue that’s really come to the forefront, particularly with the recent spate of suicides of young clinicians. We need to recognise the privations and difficulties that always challenge doctors when they go rural and we have to understand how to build resilience in our rural doctors.”

Dr McPhee said other subjects that will be discussed at the conference include the ins and outs of cannabis prescribing, and also the role of the rural doctor in sports medicine.

“We’re looking at the issues around the country doctor also being for example the local rugby GP, and what are the obligations, tips and tricks around how you look after sports people in a country town where you don’t have access to sports medicine specialists – issues like dealing with concussion, minor sporting injuries or maintaining fitness.”

Dr McPhee praised several government initiatives to improve access to care in rural, regional and remote communities.

“I think the government has done a lot. They’ve legislated for a Rural Health Commissioner; they’ve created 100 extra places for rural specialist training. They’ve developed the Junior Doctor Training Innovation fund and they’re in the process of allowing universities to develop rural training hubs to facilitate regional training of clinicians, be they specialists or generalists. There’s a lot happening in rural, but we still need to see greater investment in primary care. Funding for primary practice is at its lowest ebb – we need different models of funding and care that lead to sustainable clinicians, making sure they stay in the region and are supported in the long term.”

He said the medical training of Aboriginal and Torres Strait Islanders was another key issue in rural and remote medicine.

“Our goal is to have 1,000 Indigenous medical practitioners, and we’re sitting at around 200-300 at the moment. They absolutely need our support and we need to ensure First Nations people have the opportunities to get the training they need to become clinicians in their own communities. We’re still not doing enough and there’s no doubt it’s one of the issues we need to address.”

Rural Medicine Australia is the key annual rural medicine conference in Australia, and is jointly hosted by ACRRM and RDAA. You can access the program here.

Have a rural job vacancy? Doctorportal Jobs makes recruitment easy.  Just select the Rural General Practitioner option when you post a job to reach the most qualified candidates.  Or if you’re seeking a rural placement, sign up to post a private resume and let employers find you.