Further progress on rural generalist recognition

An application to recognise Rural Generalist (RG) as a new field of specialty medicine continues to move forward, with the RACGP welcoming any proposed national recognition of GPs’ skills and appropriate remuneration.
 
Following public consultation in late 2023, the Australian Medical College (AMC) reported to the Medical Board of Australia, supporting the assessment of a joint application by the RACGP and Australian College of Rural and Remote Medicine (ACRRM) and demonstrating a case for recognition of RG as a new specialty field.
 
In December 2024, the second and final stage assessment of the joint application to the Medical Board for RG specialist recognition was completed.
 
The Board is now due to make a decision on whether to recommend recognition to Australia’s health ministers, with outcomes expected in the first half of this year.
 
RACGP Rural Deputy Chair and medical educator Dr Rodney Omond welcomed the progress of the recognition process, following years in the making.
 
‘This has been a project through the RACGP Rural Council and faculty for a number of years, and it’s great to see there is further progress towards recognition of the fact that rural GPs can have extra specialist skills and utilise them effectively for their rural communities,’ he told newsGP.
 
‘The college is really keen on being able to provide these extra skills in clinicians in rural and remote communities.
 
‘The focus is on the needs of the local community and supplying those needs, and because there aren’t members of other specialties available in a lot of rural places, local GPs have the opportunity to gain special skills and use them for their communities.
 
‘This recognition is just a formal way of saying that these are a particular type of specialist skill, and they are a valid skill from a clinician point of view.’
 
In 2019, the RACGP endorsed the National Rural Generalist Pathway in collaboration with the ACRRM and approved development of the RG Fellowship to align with the new pathway, which was launched in 2022.
 
If the new specialist RG field is recognised it will be incorporated into national law and included on the national register of specialties. Doctors with an approved RG Fellowship qualification will be able to apply for specialist registration in the new field.
 
According to the RACGP, RG medicine forms an important part of rural and remote primary health service delivery, particularly in areas of specialty workforce need, and recognition will help to ensure a strong future workforce.
 
While the process varies across state and territory jurisdictions, Dr Omond says moving towards a national, formalised recognition will ‘hopefully ensure an easier process for GPs’.
 
In addition to the RACGP–ACRRM joint application, the Rural Doctors Association of Australia (RDAA) has been tasked with exploring the inclusion of RG-specific MBS item numbers to enhance rural patients access to services to ensure the validation of skills for payment through the Medicare system.
 
Dr Omond said the RACGP supports this project.
 
‘It’s very likely we’ll agree with what they say [once completed], because they have the same issues about rural GPs not being paid for the work they do,’ he said.
 
‘If other doctors do this particular thing, then a GP with the skills should be paid the same amount for Medicare – that’s what we’re after.
 
‘If we’re doing the same thing as a specialist at another college, we should get paid the same amount if those skills are recognised, and recognised as equal.’
 
The third stage in the recognition process is for credentialling in hospitals and area health services for GPs to work in the relevant RG skill area, where the institution then recognises that qualification also as an RG.
 
Dr Omond said the college would then expect the rural area health services to pay GPs appropriately for those skill levels, because they are recognised ones.
 
‘GPs have often been paid very little for doing specialist work in hospital, so that’s been a problem,’ he said.
 
‘They’ve got the skills, but that has just not been recognised … so has not been paid. And of course, that unfortunately means that for GPs it becomes more difficult to justify why they should do that extra work.’
 
Dr Omond said as well as recognition of RG skills, national changes will also give ‘reasonable recognition’ to the skills GPs have, which supports the rural workforce.
 
‘So there’s a bit more to it than just the rubber stamping of the whole thing,’ he said.
 
‘Overall, progress on this recognition is really positive and this is a very good thing for rural GPs.
 
‘And while rural generalism is a really important move, the RACGP does recognise the ongoing work of members who do rural general practice without a particular specialty skill or RG who are also seen as valuable for our college.’
 
The AMC’s final report is due in early 2025.
 
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ACRRM GP workforce rural general practice rural generalism rural medicine