New initiative provides rural doctors with their own GP

An exciting health service has opened this week to provide much-needed local healthcare to frontline health workers in outback Queensland.
 
From 1 May, rural doctors, nurses and allied health professionals in the remote Queensland towns of Quilpie, Charleville and Cunnamulla, have been able to access both face-to-face and telehealth consultations through the new GPs4RuralDocs program.
 
The program has been commissioned by the Rural Doctors Foundation (RDF) to provide independent, accessible primary healthcare, with a goal of keeping health professionals in their communities. It is part of an overall preventive strategy to sustain the rural and remote workforce, in light of recent data indicating that GPs working in these areas are more likely to retire in the next 10 years than those working in major cities.
 
Like anyone else living in remote communities, rural GPs often face significant barriers when trying to see a doctor, such as lack of available local services or having to travel long distances to seek care.
 
A recent RDF survey featuring more than 125 respondents found that 42% of doctors needed to travel out of town to receive healthcare, with 20% travelling more than 800 km to do so.
 
Rural GPs also experience challenges unique to their profession, such as having to find someone to cover their on-call work while they take medical leave.
 
The RDF survey found that almost one in four rural doctors worked over 60 hours per week. Of those working in remote towns, 32% were the only doctor in town and a startling 70% received no work relief to attend to their health.
 
Queensland GP and medical director of GPs4RuralDocs, Dr Margaret Kay, says that the program seeks to overcome these barriers by providing independent rural GPs with crucial lived experience to visit health workers in their own communities.
 
‘Maintaining rural doctors in the communities is difficult and at the heart of the problem is access to regular, independent, confidential healthcare,’ she told newsGP.
 
‘We don’t want our rural doctors to suffer and then become burnt out. Nor do we want them to miss out on their health because they have to leave town.’
 
Maintaining confidentiality in small communities where resources are shared between country practices and hospitals, often staffed by friends and family – is another challenge faced by rural GPs.
 
These compounding issues cause many rural doctors to either treat themselves or forgo their own healthcare altogether in favour of always being there for their patients.
 
Rural GP and RDF chair, Dr Michael Rice, emphasises that confidential appointments with independent GPs is a crucial part of the program. While GPs4RuralDocs practitioners will be working collaboratively with local services to deliver the best care, records will be not be stored within the patient’s hometown in order to maintain confidentiality.
 
‘Doctors, like everybody else, need healthcare that is reliable and trustworthy,’ Dr Rice told newsGP.
 
‘It is not acceptable or desirable that we as rural GPs are treated by our family members, our employers or our trainees and supervisors.
 
‘Proper care means more than just a script or just a referral, and keeping our rural colleagues physically and mentally well means they shouldn’t be DIY doctors.’
 
Dr Konrad Kangru, RACGP Rural’s Queensland representative says the college is fully supportive of the program, which has taken three years of work and planning to establish.
 
‘This project has been a very long time coming,’ he told newsGP.
 
‘The importance of providing effective healthcare to remote GPs was identified generations ago … so the program is essentially indicating to these doctors that we see you, we value you and we will come to you.’
 
He feels that GPs in remote Queensland, many of whom are international medical graduates, are particularly isolated and vulnerable.
 
‘They don’t have close professional or peer support and they can’t abandon their own community to go and seek the care that they need,’ he said.

‘Often, these are overseas-trained doctors who have to worry about having only partial MBS eligibilities and must agonise as to whether or not taking time off to seek medical care might negatively impact their employment or visa status.’
 
The RDF and RACGP hope that success of this pilot program in remote Queensland will attract the funding required to expand the program nationally.
 
Dr Kay maintains that the program has been carefully considered and implemented with consultation and feedback from stakeholders. Feasibility studies have been also conducted and memorandums of understanding have been sought to ensure that while the service is delivered by independent visiting rural GPs, it is delivered in a safe and effective manner using the appropriate regional referral pathways and troubleshooting contacts.
 
‘Healthcare for rural doctors is not a new idea. However, this is the first time it has been delivered in this region in such a collaborative and systematic manner,’ she told newsGP.
 
‘We are confident that the high level of clinical governance, variety of modalities and flexibility of the program means that it will be readily reproducible across the nation.’
 
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