Andrew Swayne1, Diann S Eley. 1. The University of Queensland Rural Clinical School Research Centre, Toowoomba, Queensland, Australia. andrew.swayne@uqconnect.edu.au
Abstract
OBJECTIVE: The practice of rural and remote medicine in Australia entails many challenges, including a broad casemix and the remoteness of specialist support. Many rural practitioners employ advanced procedural skills in anaesthetics, surgery, obstetrics and emergency medicine, but the use of these skills has been declining over the last 20 years. This study explored the perceptions of rural general practitioners (GPs) on the current and future situation of procedural medicine. DESIGN: The qualitative results of data from a mixed-method design are reported. Free-response survey comments and semistructured interview transcripts were analysed by a framework analysis for major themes. SETTING: General practices in rural and remote Queensland. PARTICIPANTS: Rural GPs in Rural and Remote Metropolitan Classification 4-7 areas of Queensland. MAIN OUTCOME MEASURE: The perceptions of rural GPs on the current and future situation of rural procedural medicine. RESULTS: Major concerns from the survey focused on closure of facilities and downgrading of services, cost and time to keep up skills, increasing litigation issues and changing attitudes of the public. Interviews designed to draw out solutions to help rectify the perceived circumstances highlighted two major themes: 'synergy' between the support from medical teams and community in ensuring 'sustainability' of services. CONCLUSIONS: This article presents a model of rural procedural practice where synergy between staff, resources and support networks represents the optimal way to deliver a non-metropolitan procedural service. The findings serve to remind educators and policy-makers that future planning for sustainability of rural procedural services must be broad-based and comprehensive.
OBJECTIVE: The practice of rural and remote medicine in Australia entails many challenges, including a broad casemix and the remoteness of specialist support. Many rural practitioners employ advanced procedural skills in anaesthetics, surgery, obstetrics and emergency medicine, but the use of these skills has been declining over the last 20 years. This study explored the perceptions of rural general practitioners (GPs) on the current and future situation of procedural medicine. DESIGN: The qualitative results of data from a mixed-method design are reported. Free-response survey comments and semistructured interview transcripts were analysed by a framework analysis for major themes. SETTING: General practices in rural and remote Queensland. PARTICIPANTS: Rural GPs in Rural and Remote Metropolitan Classification 4-7 areas of Queensland. MAIN OUTCOME MEASURE: The perceptions of rural GPs on the current and future situation of rural procedural medicine. RESULTS: Major concerns from the survey focused on closure of facilities and downgrading of services, cost and time to keep up skills, increasing litigation issues and changing attitudes of the public. Interviews designed to draw out solutions to help rectify the perceived circumstances highlighted two major themes: 'synergy' between the support from medical teams and community in ensuring 'sustainability' of services. CONCLUSIONS: This article presents a model of rural procedural practice where synergy between staff, resources and support networks represents the optimal way to deliver a non-metropolitan procedural service. The findings serve to remind educators and policy-makers that future planning for sustainability of rural procedural services must be broad-based and comprehensive.