‘It really is the time of the GP’: Q&A with new RACGP Rural Chair

‘For every one COVID case that makes it into an ICU [intensive care unit], there’s a good hundred people with high-risk COVID symptoms that are seeing their GP, and another 500 that are worried about COVID and are seeing their GP for anxiety, stress, financial distress.
 
‘The fires, the floods, really made it clear that we need our GPs more than ever and, with the right support, we really can support our communities to come out of this better.
 
‘It really is the time of the GP.’
 
Dr Michael Clements has firsthand experience of how GPs can support their communities, having been heavily involved in the disaster relief response during the devastating 2019 floods in Townsville that caused widespread devastation.
 
Now, 11 months on since being elected Deputy Chair of RACGP Rural, he has stepped up into the role of Chair.
 
Dr Clements spoke to newsGP about what the new role means to him, his objectives, and how he hopes to support rural and remote GPs during the coronavirus pandemic.
 
What do you hope to achieve as Chair of RACGP Rural?
I’m very pleased to get the opportunity to represent our rural and remote members by chairing the Rural Council, but also representing their views to the Board.
 
I’ve been involved in rural medical education and training ever since becoming a Fellow and through some work with Queensland Health and the Rural Generalist Pathway, and then through joining the RACGP Queensland Council and then the Rural Council.
 
I’ve been seeking to provide some more structured support to the college in terms of contributing through the council mechanisms … so I’ve been very much looking forward to this, and I was very pleased to step into the Chair role, despite the sad circumstances.
 
I’ve got a few things on my mind that I’d like to be able to achieve in our time, and one of the big priorities at the moment is supporting the rural members as we move towards the new Rural Generalist [Fellowship] FRACGP–RG ticket. This is quite a progressive step forward from where we’ve been, and it’s modernising the FRACGP, and making it relevant for the needs of the community moving forward.
 
So moving forward with the RG agenda is important to our rural members, but also continuing to support our rural members that are not training towards the RG endpoint – and may not want to – just continuing to provide them with high-level education standards and support in the national sphere so that they can continue to do their important cornerstone work in these rural and remote practices.
 
How do you plan to ensure the concerns of the RACGP’s rural membership are heard?
One of my backgrounds is in both clinical and corporate governance, so I do have a Fellowship in Medical Administration as well – but I’m always a GP at heart.
 
So one of my agendas is to get the most out of the Rural Council. What that means is we will be introducing and connecting our Rural Council members to the wider rural membership, we’ll be encouraging our rural members to engage with our council members, so we can reflect our members’ interests through the Rural Council and then present them in an effective manner to the Board.
 
So one of the agendas is absolutely making the Rural Council members more visible and interactive with their rural membership in the various areas.
 
How will you seek to support rural and remote GPs, particularly during the pandemic?
My background also includes working in rural hospitals and as a rural and remote GP, but also as a practice owner. So as a practice owner during the COVID outbreak, [I have been] leading the practice through the immense number of changes in procedures, even in terms of billings and the IT.
 
But [also] leading the teams through what’s now becoming a risky profession, and our rural GPs are facing greater risks than ever before – both physical risks from catching COVID themselves, but also financial risk and practice viability throughout lockdown.
 
[So] I’m not unaware of the significant challenges facing our rural members in the next 6–12 months.
 
But this is also a time where the rural communities need us the most, [and] this is where GPs really shine. We’ve got the big hospitals, treating a small amount of the population but, by and large, the majority of the population will continue to seek out their GP for advice, reassurance, treatment, and continuity of care. And so now, more than ever, we need our GPs to be more supported.
 
We know that our rural members are concerned for themselves, but, most importantly, for their community. They live, breathe, work [and] socialise with the people around them, and the pain of the community is their individual pain as well. In the same way, we know rural members are being supported by their communities.
 
We’ve got an important role to ensure that in all of the COVID, the federal and the state-led COVID responses, that they’re rural-appropriate and rural-ready, and [that] there’s a regional and rural lens applied to the recommendations and decision-making made by these decision making authorities.
 
That’s our job as a Council and my job as Chair to represent that when I meet with the politicians.
 
In light of the GP shortages, and reflecting on your own experiences, what do you think it takes to attract GPs to rural medicine?
 
I was lucky to have very good rural exposure during my medical school training at Sydney University, where I was able to put my hand up for a wide variety of very rich rural experiences. And then even when I joined the Air Force – I was in the Air Force for 13 years – I was placed in remote areas –  Katherine in the Northern Territory for three years, did some training in Geraldton [in WA], and a deployment when I was in the Middle East that [was] very much like a rural remote clinic environment.
 
Even Townsville, which is relatively regional and relatively big, after the Townsville floods we had that sense of connection to the community. The role of the rural GP in the community to reflect their interests, to advocate for their patients in the community, and to help bring them out of disaster was ever-present and certainly evident.


Dr Clements’ neighbours were evacuated after having to seek refuge from encroaching floodwaters in the 2019 Townsville floods.

So the thing that’s attracted me and kept me doing rural and regional medicine is the connection to community. I’ve certainly really gained a lot professionally and personally by being connected to the rural towns that I’ve worked in.
 
Every RACGP GP is rural-ready. And it’s not just about people who undertake the Rural Generalist Pathway, or the rural pathway. It’s about meeting community need, which can be from hospital-based GPs all the way through to fly-out GPs from urban areas that support rural communities.
 
The college trains across that full spectrum, and supports members across that full spectrum, and we need to ensure that we keep providing training, education and governance around the standards that are required so that we can continue providing that high level of care.
 
We know that there’s an absolute shortage of medical workforce, just total numbers, in our rural and remote areas, which makes it even more important that those medical staff that are out there are as generalist as possible. So it’s important that our GPs are supported by the college to broaden the confidence and the skill base of all of our rural GPs so that we can better the community need.
 
It’s a long game to try and start distributing more doctors and workforce out to the rural region areas. But while we’re waiting for many of those systems to take place, it’s important that each of those doctors that are out there are getting represented and supported.
 
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Visit the RACGP Rural Awards website to nominate a GP or GP in training for outstanding achievements and exceptional individuals for their contribution to rural general practice.

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