Bringing choice to female patients in rural towns

Amanda Lyons

10/05/2018 1:43:00 PM

The Rural Women’s GP Service aims to offer choice and close healthcare gaps for female patients in small towns across Victoria.

Lisa Greenhill (left) is unequivocal in her support of the program. ‘I can’t say how much of an asset it is in this community,’ she said.
Lisa Greenhill (left) is unequivocal in her support of the program. ‘I can’t say how much of an asset it is in this community,’ she said.

Family, community, a relaxed outdoors lifestyle, the undeniable beauty of the landscape. These are some of the things people love about living in the country.
But for many in rural areas throughout Australia, this lifestyle also includes a relative lack of access to health services.
Lisa Greenhill, who returned to the small town of Corryong – a five-and-a-half hour drive from Melbourne – after nearly 30 years of city living, has definitely experienced these issues.
‘I think it’s sad we miss out on good treatment,’ she told newsGP. ‘You shouldn’t have to miss out because you live rurally. We all pay the same health fund money, but we don’t get the same treatment.’
Twenty per cent of people in rural areas have reported not having a GP nearby as a barrier to accessing care, as opposed to 3% of people in major cities. And when a small rural community does have a local practice, it is not uncommon it will have a solo, male GP.
This situation can have a significant impact on health outcomes for rural women, who may often feel uncomfortable discussing particular issues with a male doctor.
‘I just felt my needs weren’t being met any more by a male GP,’ Ms Greenhill said.
The problem of lack of access to female doctors in the country was recognised by the Royal Flying Doctor Services (RFDS) Victoria, which in 1999 launched the Rural Women’s GP Service (RWGPS) to help provide a solution.
The program sends female GPs on a six-to-eight-week rotation to rural and remote towns that have no female GP within 50 km. The RWGPS provides eight clinics each year, all of which are 100% bulk-billed, and its doctors see an average of 800 patients each year.
Dr Mary-Anne Lancaster, a Melbourne-based GP who travels to Corryong for the RWGPS, explained that the service is intended to provide choice for local patients, not competition with existing GPs.
‘You can’t go in unless the program has the agreement of the local GPs,’ she told newsGP. ‘Most of the time, it is very well received by the local male GPs.
‘It might be that the last time they did a Pap smear was 10 years ago, but apart from that, they enjoy knowing that their patients are being serviced and don’t see it as competition, but as assisting their patients.’

Dr Mary-Anne Lancaster, who has worked with the RWGPS for almost 17 years, emphasised the fact the service is intended to provide choice for local patients, not competition with existing GPs.

For Ms Greenhill and many other women living in places like Corryong, the RWGPS has been invaluable.
‘Having access to a doctor that gets you means everything for a woman, and bringing that into a country area. I mean, we usually have to travel hours to get that sort of stuff,’ she said. ‘And a lot of people can’t do that. The majority of our community are elderly, or they’re not cashed up to travel.’
Some Corryong residents have found the service literally life-changing.
‘I was talking to a friend about her 75-year-old mother and she said, “Mum’s so cranky”, and I said, “Have you ever thought she still could be menopausal? I really think you should go and see Mary-Anne and have a chat,”’ Ms Greenhill said.
‘So she went, and Mary-Anne picked up that she was still in menopause and was able to treat it. [My friend’s mum] said, “I just can’t believe the difference, I’ve put up with this for years, I just feel magnificent”. She has a life now.’
Dr Lancaster has found that rural women’s health issues are often further compounded by what has become known as ‘rural stoicism’ – a tendency for people in rural areas to delay seeking help for longer than their urban counterparts.
‘A lot of women in the country are not very good at coming in for what you or I would consider fairly significant issues,’ she said. 
‘Country women come almost apologising – “I’m sorry, I didn’t want to bother you” – and sometimes you see stuff they’ve been sitting on for quite some time when they probably shouldn’t have.
‘When they do report symptoms, it’s usually pretty significant.’
Mental health can also be a substantial issue for Dr Lancaster’s patients in Corryong.
‘The first few years when I went to Corryong there was a drought that went on for five to eight years and there were a number of suicides in the area among farmers. They were incredibly stressed, the finances were incredibly tight, some of them are living on overdrafts the size of a mortgage,’ she said.
‘Those women were in real emotional strife.’
It can be helpful in these situations for people to have an appointment with someone who does not live in the town.
‘I think they trust the local GPs, but knowing that they’re going to be seeing them down at the local footy field and the local supermarket or wherever, it’s harder to open up,’ Dr Lancaster said.
‘There’s only one practice in town – they just have to go for something else and the GP will open the file and see what’s going on.
‘So they are probably happier knowing that they are not going to be meeting me regularly down the street.’
Dr Lancaster enjoys her regular travel to the country. She has been with the RWGPS for almost 17 years, travelling to Corryong for eight, and believes the RWGPS delivers something vital to her rural patients.
‘It is providing choice in areas where a lot of compromise has to be made in healthcare,’ she said.
‘For example, to get radiotherapy for their cancer treatment they have to travel one and a half hours each way – sometimes every day of the week they’ll be travelling three hours a day.
‘So this is one area where they are happy they don’t have to make a compromise. They can see a female GP, or a male GP, but they’ve got choice and that’s the whole point.’
Ms Greenhill is unequivocal in her support of the program.
‘It’s really positive,’ she said. ‘I can’t say how much of an asset it is in this community.
‘It means a lot to a lot of women.’

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Bernadette Hunt   24/05/2018 10:14:03 PM

I am a female GP and would like to contribute to the work of the RWGPS / RFDS in Victoria. Could you advise who would be a point of contact please?
Thank you.