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Episode 16

Rural generalism

Show notes

Welcome to Generally Speaking, the conversation for all GPs.

Join GPs Dr Gill Singleton and Dr Billy Stoupas as they discuss some of the most pressing topics and issues surrounding the operations of a general practice.

This time, Dr Stoupas and Dr Singleton get to the heart of the rural general practice story and discuss the issues surrounding regional health in Australia. They are joined by Dr Michael Clements, RACGP Rural Chair, Northern Australia Primary Health Ltd (NAPHL) Chair, and owner and Director of Fairfield and Townsville Central Medical Practices. They are also joined by Natasha Greenwood, General Manager of Regional and Agribusiness for CommBank.

07 October 2020 - 01:58 PM | 26 min 41 sec

(00:21) Dr Singleton and Dr Stoupas set the scene regarding healthcare in regional Australia and in acknowledging the changes due to COVID-19 such as telehealth, but also the fact that in 2020 the postcode in which you live is still a health risk factor. Australians in rural areas are much more likely to die before they should, develop preventable diseases and have difficulty accessing healthcare. 

Introduction of Dr Michael Clements and Natasha Greenwood

(002:02) Natasha and Michael each tell their backstory and what it is about regional and rural Australia that they find so compelling.

(03:44) Dr Clements responds to Dr Singleton’s question regarding the challenges that we’re currently experiencing in rural practice. Despite large numbers of medical students and large numbers of GPs in training, it is still difficult to place them in rural and regional areas. The challenge moving forward is how to approach the rural workforce as a whole system.  

(04:42) Natasha Greenwood offers her insight into this issue and notes that it is one that most regional businesses face in not only attracting quality talent but also retaining them. So, it is not unique to the medical profession. She believes that the industries that do well in this endeavour, embrace different ways of working, for instance remotely. It’s important to remember that either a spouse or partner might also need to find work, gain access to good quality family amenities, or seek ongoing educational opportunities to keep them motivated to stay in a rural area.

(06:44) Dr Clements discusses his role on the RACGP Rural Board to which he has been elected Chair. The agenda is very clear and that is to support rural members who in turn support rural communities. Also to encourage future rural doctors to the workforce by giving them a dedicated training pipeline and mentorship connections, and by demonstrating that the training and education opportunities are there for their needs – both now and into the future.

(07:54) Dr Clements outlines the difference and similarities between the RACGP and the Australian College of Rural and Remote Medicine (ACRRM) training, and makes the point that both have the rural generalist as the endpoint, with the key similarity that both pathways allow a flexible way of attaining Fellowship. One of the main differences is that the RACGP gives the flexibility of a three-year Fellowship for broad baseline skills with the option of a fourth year to obtain advanced skills. With ACRRM, you’re signing up for the advanced skills at the start, and committing to a four-year program.

(11:10) Dr Clements responds to Dr Singleton on the question of numbers of young GPs in rural areas. He figures that you’ll often find that from a cohort of final year medical students, many of them want to save the world, do missionary work overseas and would say that they are committed to rural values and outcomes. But when it comes down to it, life often gets in the way, and that might take the form of any number of things. The good thing is that there is flexibility in the training and young people can adapt along the way if life happens.

(12:58) Natasha Greenwood discusses the next GP Insights Report which is due in October. She outlines a few topline findings ahead of its release.

(16:23) Dr Stoupas follows up with a question about rural practice customers and if Natasha had any particular insights. She suggests that surrounding yourself with advisers and consultants who you trust is a solid approach. So, GPs in the country should have a working relationship with a specialist accountant, banker or lawyer, someone who deeply understands healthcare. She also recommends establishing a practice business continuity plan, and finally, ensuring that you take care of your own health and wellbeing because our frontline healthcare workers are absolutely integral.

(19:30) Dr Clements talks about the rural patient­–doctor ratios. In rural and remote areas, they are stretched and rural doctors might be covering both emergency overnight and on call, as well as the day-to-day clinic consulting rooms. The patient­–doctor ratios are the best in the Sunshine Coast where a lot of doctors want to live, and are worse the further out you look.

(21:38) On the question of poorer health outcomes in rural areas, Dr Clements remarks that it’s very multifactorial. Distances are an issue, investment from both the state and federal governments in terms of getting some of the technology out to rural areas is an issue too. Improving the non-GP specialist retention and training in rural areas would also go a long way to improving the outcome.

(24:55) Dr Singleton thanks the guests and Dr Stoupas mentions a conversation that he had with Natasha before the record on the topic of healthcare bankers. In his experience they made a huge difference in his ability and ease to buy into a business.

  • Details on the RACGP Fellowship in Advanced Rural General Practice (FARGP) is available here.
  • More information about ACRRM’s training, assessment, certification and continuing professional development in the specialty of general practice is available here.

‘If you don’t currently work with an industry specialist in your close advisory team – whether that’s your accountant, your banker or your lawyer – think about how you might be able to engage someone who deeply understands healthcare and innovate your alternative talent pipeline.’

– Natasha Greenwood

‘A truck driver at a remote mine site in WA gets paid a bucket-load more than a driver in Perth city. But we don’t have the same differential for doctors. A doctor’s pay in the middle of Perth is actually not that much different to in the Pilbara. Maybe a little bit, but not different enough. Not like the mines. We need to learn from that.’

– Dr Michael Clements

  • If you would like to learn more about Dr Michael Clements’ experience and insights, or would like to connect, visit his LinkedIn here
  • If you would like to learn more about Natasha Greenwood’s experience and insights, or would like to connect, visit her LinkedIn here
  • If you would like to learn more about Dr Gill Singleton’s achievements and insights, or would like to connect, please visit here.
  • If you would like to learn more about Dr Billy Stoupas’ achievements and insights, or would like to connect, please visit here.

Resources referred to in the Generally Speaking podcast and on the website are views of the hosts and not necessarily endorsed by RACGP.

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