Working together to improve rural health
BY DR SANDRA HIROWATARI, CHAIR, AMA COUNCIL OF RURAL DOCTORS
My regular readers will know that I believe conferences are important for rural doctors. They allow us to come together to discuss the big issues and to form connections we can call on when we return to our often isolated communities. In October, I attended RMA19, along with about 1,000 other rural doctors.
The nature and personality of this conference is unique. It reflects us. We are opinionated, passionate and we fight for what we believe in. We are a culturally diverse, family oriented, gender diverse just bunch of doctors who do not take the easy path.
So, the event reflects us.
A strong spousal and family program is a key element in RMA. It reflects what we need to keep us rural – our families.
A big focus on women’s health and women in our medical workforce. This is so refreshing when other conferences have difficulty getting panelists who represent us.
A unique keynote speaker from Chinese presented on an unpleasant concept – the ‘nobody’ GP.
Another highlight every year is the Presidents’ breakfast where presidents from major players in rural medicine share the stage to discuss rural health. This year, the AMA was represented by our well-spoken Vice President Dr Chris Zappala, in a broad ranging discussion on systems and structures that drive quality in health care.
Despite a sometimes hostile audience, Dr Zappala spoke eloquently and passionately about the importance of strengthening rural primary care. In fact, one of the more negative moments of the conference led to one of the most positive statements from our Vice President: collegiality is what is needed now, not stone throwing.
This became more apparent as the discussion moved to the challenges ahead for the National Rural Generalist Pathway (NRGP). There are many hurdles to a fully realised NRGP, but one the AMA is increasingly concerned about is the lack of a standardisation of credentialing requirements. This is a crucial component of the NRGP but there has been virtually no discussion about it from the Government or the Department of Health.
One of the challenges noted by the panel was interprofessional disagreement about the requirements for professional qualifications, access to non-GP MBS rebates for accredited additional skills, and determining scope of practice. Again, Dr Zappala rose above the squabbling and blaming to make the point that this is an issue for the entire medical profession. We as doctors need to resolve this – no one else is going to do it for us.
The good news is that the work has started. Earlier this year, RDAA released their position statement Credentialing and defining the scope of practice of Rural Generalists. The position statement calls for the development of national guidelines for determining the scope of practice and the credentialing, nationally consistent processes for collecting documentation, and ensuring continued and meaningful involvement of rural doctors in the development and review processes.
The AMA supports this position statement and we want the Federal and State/Territory Departments of Health, the Colleges, and the other organisations to start working towards the achieving nationally consistent credentialing processes and scope of practice definitions.
To achieve this, we need to start working together. It helps nobody when we try to divide the profession by the letters after our names. We need to work together because our rural communities are suffering.
A final highlight for me was the Great Debate, a comical debate about what works better to encourage doctors to go rural – carrots or sticks. The debate ended spectacularly with Dr John Hall physically carried off the stage by a fellow rural doctor as he over ran his allotted debate time.
RMA19 also saw the same Dr John Hall assume the role of President of RDAA for the next two years. John has been a strong AMA advocate, so our AMA President, Vice President and the Council of Rural Doctors are looking forward to working collaboratively with him and RDAA.
I am also looking forward to seeing him carried off stage again at RMA20.
Published: 13 Nov 2019