Executive Summary: Australians who live in cities have better health outcomes than Australians who live in rural and remote areas. Rural communities have fewer doctors and are finding it increasingly difficult to attract new ones. Rural patients access Medicare at far lower rates than metropolitan patients and wait longer to see their GP. Rural doctors are up against it, and it feels like no one is paying attention.
In conducting the 2019 AMA Rural Health Issues Survey, we set out to hear what our rural doctors were saying. We wanted to identify the urgent priorities to begin to improve the health outcomes of our communities. Rural doctors – we asked you to tell us, and you did.
One of the major challenges when conducting a survey of Australia’s rural doctors is that we all work in vastly different areas. Our communities have their own unique issues, we may have state of-the art equipment in our hospitals (but lack staff to use it) or we may be the only doctor for hundreds of kilometres around. One doctor may be supporting their community through the complex challenges of a drought while another is battling the waterborne diseases unique to the Wet Season. Regardless of the challenges, rural doctors do their best.
Our challenge now is to produce policy that will support all of our rural (and regional and remote) doctors and improve the health outcomes of their communities. We have started by listening to these doctors. We have listened, and we will base our policies on what we have been told.
In 2019, rural doctors told us that their top 10 priorities are:
1. The need for extra funding and resources to support improved staffing levels at rural hospitals;
2. Encouraging medical colleges to include rural rotations for trainees to rural areas;
3. Ensuring that rural hospitals have modern facilities and equipment;
4. The need for access to high-speed broadband for medical practices, encompassing general practice and specialist practice (reflecting the increasing use of telehealth);
5. Increasing the available infrastructure, resources, and supervision to support the training of junior doctors in rural areas;
6. Establishing regional training networks to enhance opportunities for specialist training in rural areas and support rurally based career paths;
7. Establishing more integrated programs to allow rural doctors to maintain and upgrade their procedural skills in public hospitals;
8. Increasing incentives, such as rural incentive payments, to recruit/retain doctors to work in rural areas;
9. Ensuring general practitioners with recognised procedural skills can access appropriate hospital credentialing and facilities; and
10. Increasing funding for ancillary staff at rural hospitals.
Despite significant investments in rural health since the last Rural Health Issues Survey in 2016, the results have changed minimally. Nine of the top 10 priorities in 2016 are priorities again in 2019.