Making health work in rural and remote Australia
The specialty of medical administration is particularly important for effective care delivery in rural remote areas. The health systems of rural and remote regions are characterised by dispersed populations, long distances to specialised care, and challenges to attracting clinical skills to work and stay in the area.
We profile two doctors currently working in Director of Medical Service roles in Katherine and Alice Springs. Dr Louise Harwood and Dr Samuel Goodwin are currently undertaking the RACMA fellowship, and have both been working in remote regions of the Northern Territory and Central Australia for the last decade.
Louise worked as a GP in Tasmania before taking her family to Timber Creek in the Northern Territory nearly 10 years ago. While she had originally planned to go to the Northern Territory for one year, she found the work fascinating and stayed on. Louise became Director of Medical Services at Katherine Hospital in 2014.
Louise said, “The work is very rewarding. It is constantly utilising the full skill set I bring to my work, including medical knowledge and expertise, communication skills, and most importantly knowing your resources”. “It’s also very satisfying as a DMS to be able to apply these skills at a regional population level”, she said.
Sam initially trained as a rural generalist in the Northern Territory. He has advance practice qualifications in anaesthesia, and is a Fellow of the Australian College of Rural and Remote Medicine. After graduating from James Cook University, Sam undertook further training in remote areas of the Northern Territory.
His recent experience includes working at Tennant Creek Hospital, where he established telehealth and training of medical staff. Sam said, “It is important to train a local workforce. Relying on placing people into the local workforce doesn’t always work if this means the health service becomes reliant on locums. This results in high turnover and a lack of familiarity on how to work with the people in the local area”.
Both Louise and Sam describe the challenge of isolation, the need for a broad skill set, and to adapt with what you have as critical to their roles. Louise said, “There is an excellent and talented team of clinicians here. As Director of Medical Services, I facilitate and work on management issues such as recruitment, so that the team can go ahead and just do their work. Sometimes I have to roll up my sleeves and do clinical work. This comes with working in a rural setting”.
They talk about the uniqueness of their communities. Louise describes Katherine as having a high Indigenous population, and a further challenge is the high level of homelessness in the region. The hospital is currently working on a project with other services in Katherine to further improve coordination of care for people disconnected from health and social services as a consequence of alcohol. She says, “Katherine Hospital is fortunate to have good relations with other service providers, and through this we are able to provide integrated and person centred care. Access to health services at different levels and which people feel comfortable in engaging with, is important for delivering improved health outcomes.” Describing the hospitals ‘open door’ approach to such patients requiring end of life care, she said, “The right supports need to be in place, but if people are free to come and go, they are more likely to return when they need to.”
Sam, now Executive Director of Medical Services at Central Australia Health Service based in Alice Springs, says, “I was attracted to work in remote areas as I wanted to address the disparity experienced by people accessing health care in these areas”. He enjoys working in a remote setting as he likes the variety of work, enjoys working with, and is humbled by, the incredibly talented and dedicated clinicians he works alongside, and he finds the community in remote settings are appreciative and supportive of their local health service. However, Sam describes his most satisfying experiences as seeing efforts to improve the health service in the area as paying off – such as the opening of the teaching and training facility at Alice Springs Hospital, or obtaining increased medical support. He said, “It can be a struggle, but when it comes off, then it’s worth it”.
Ms Gaye Britt
RACMA National Office
Last Updated on Wednesday, 12 April 2017 16:56