Why specialist doctors are heading to the bush

New research from the Melbourne Institute, for the first time in Australia, reveals the scale of specialist doctors traveling to rural areas for outreach work, and the reasons behind this drive.

A third of Australians live in rural areas, where only 15 per cent of medical specialists work, so having specialists travel for outreach work is crucial in many parts of the country.

The first national survey of its kind in the world, the study also revealed that 20 per cent of specialists in Australia are travelling to rural and remote areas to do outreach work.

Professor Anthony Scott, Head of the Centre for Research Excellence in Medical Workforce Dynamics (MABEL), said this was an interesting finding in itself: “Before this research, nobody knew the scope of specialists doing outreach work.”

The study looks at both fee-for-service (private) practitioners, which make up about two thirds of the specialists, and salaried specialists, who are mostly based in large public (government-funded) hospitals.

Professor Scott explained that while some specialists may do regular days in a rural clinic, others’ work could be more ad-hoc.

Specialists driven by diversity

The research, conducted as part of the MABEL study, found most specialist doctors do rural outreach work to support the growth and diversity of their main practices.

Because people in rural areas usually need to travel some distance to access healthcare, they often delay getting the help they need, meaning their situations are more complex by the time they get treatment.

Around a fifth of all specialist doctors travel to rural areas to do outreach work.

“Doing outreach work in rural and remote areas gives specialists opportunities to do completely different healthcare to their usual day-to-day work,” explained Professor Scott.

Doctors like to do interesting things, and working in a rural or remote town or area gives these specialists the chance to do more diverse work, and see patients with more complex needs. Professor Anthony Scott

Just over half the specialists who took part in the survey said they provided rural outreach services to grow their practice, while about a quarter were driven by maintaining a connection to a rural area.

Eighteen per cent of participants travelled to provide complex healthcare, 12 per cent to provide health care for disadvantaged people and six per cent did the work to support rural staff.

The future of specialist rural healthcare

The research aim is to influence future policy to ensure Australians living in rural and remote areas get access to the specialist healthcare they need.

“Ensuring people have access to healthcare in rural areas will continue to be a big issue in Australia,” said Professor Scott.

People living in rural areas often have worse health than  those living in metropolitan parts of the country, and so it is crucial they get access to specialised healthcare.
“People living in rural areas often have worse health than  those living in metropolitan parts of the country, and so it is crucial they get access to specialised healthcare.”

Professor Scott added that while specialists travelling to rural areas for outreach work will continue to be important, in the future communications technology is likely to be increasingly popular.

“The future of rural healthcare in Australia will likely involve much more consultations over the phone, or via Skype and video calls, although specialists personally visiting rural areas for outreach work will no doubt continue to be important.”

The research has been funded by the National Health and Medical Research Council. You can read the full report at Human Resources for Health.