Advocacy is not for the faint of heart.
In honour of spooky season, The Medical Republic sat down with three of the doctors charged with one of Australia’s grisliest tasks: convincing Canberra that rural health matters.
After all, what is scarier than a ghoul politician?
Here’s what they had to say.
The ghost of ACRRM past
Northern NSW-based rural generalist Dr Rod Martin has now officially ended his term as president of the rural GP college.
TMR: You’ve overseen what was, symbolically, a huge piece of work – rural generalism is now a specialty. Do you have any reflections from your time as president?
Dr Martin: It feels like we’re on the map.
It means that we are getting other colleges and other organisations coming to us and wanting to partner with us and saying, “We can see that you’ve got a different way of working, a different way of thinking. And you have this very seamless and easy access into lots of the communities that we maybe can’t get our people to go to, maybe won’t ever be able to get our people to go to.”
Lots of the colleges can see the need but also see their inability to be able to deliver to that need.
Partnerships is one thing where we would have had to sit down and argue with colleges three or four years ago, and now we’re having great conversations with them and starting to slowly, maturely work on new solutions.
TMR: Is that because they’re understanding that rural generalists aren’t a threat?
Dr Martin: Yeah – we’re not coming to take your toys. We want to play with your toys for a while, you can have some of ours, and then we’ll work out who does what bits at the end.
The ghost of RDAA present
Dr Sarah Chalmers, an NT-based rural generalist who previously served as ACRRM president, is now officially halfway through her term as RDAA president.
TMR: You’re my ghost of rural presidents present. So, what’s happening in rural health advocacy at the present?
Dr Chalmers: There’s been lots of … people doing their confessions of being finally being an AHPRA registered rural generalist, and this is a journey.
RDAA has, more than a year ago, submitted a paper that was put together in consultation with all of our other stakeholders in terms of what a rural generalist MBS item number suite would look like.
We’ve submitted that. We are waiting for the department to run the bigger consultation, hoping that will happen in the next 12 to 18 months, so that this can all be costed out and put through a budget, maybe 2028.
That’s our job, to keep pushing that through.
Related
Some of the other projects we’re looking at, we’re really keen to push for SEM to stop trialling and to become just another tool in in the rural generalist box, that creates one of the ways that rural generalist trainees and fellows can be employed.
We don’t want it just in the training space.
That’s a setup, right? Train people in a single employer model environment and then kick them out of it at the end and tell them to go on and find their own roles.
We actually want it [to continue]. And from the Commonwealth perspective, it shouldn’t actually cost any money. It’s an administrative process.
The ghost of ACRRM future
Norfolk Island-based rural generalist Dr Claire Arundell has officially taken up the baton of ACRRM president.
The task ahead of her is formidable: will she be able to parlay the momentum of rural generalist recognition into MBS items?
TMR: What do you hope to see happen over the next two years?
Dr Arundell: Just getting the recognition isn’t the endpoint. It’s about how that now translates across to workforce.
Embedding rural generalist medicine codes into the MBS will benefit communities.
Already, some [doctors with advanced skills training (AST)] can access Medicare item codes for anaesthetics and obstetrics, say.
But there’s no incentive for services to provide Paeds AST expertise in a community, or mental health.
Instead, people tap into the pre-existing item numbers, but it doesn’t incentivise or appreciate those practitioners right now or encourage health services or general practices in a primary care setting to embrace that.
So, I hope that there’s appetite for that to come soon, and then hopefully we’ll see flow-on effects of practitioners taking up the non-procedural ASTs, and we know those skills are going to be so beneficial for communities.
For example, if you are living in a remote community and you need to take your child to see a paediatrician, having an RG with paeds AST, where they’re running a weekly clinic, where they’re liaising frequently with paeds far away, and having that ongoing relationship, [that saves you] … having to fly or drive for hours and days, away from your community to see someone after you’ve had your 18-month wait.
TMR: One of the things I’ve noticed walking around the Rural Medicine Australia conference is that there are so many medical students, prevocational doctors, and registrars here. It’s a very young demographic.
Dr Arundell: Yes, we have really big member groups already in our future generalist groups, as well as the registrar area.
I think we’ve known this was coming for a while … and it’s only going to continue.
We’re on track to be oversubscribed for training again this year by 35%.
What we are doing now is ensuring that [ACRRM’s] voice is there supporting them.
What are we going to do in the future? Hopefully, work on more training positions for RGs.
The thing that makes me the happiest is when I go to a location and there are medical students or junior doctors that come up and say, “I really want to be an RG”.
Like, 10 years ago, that wasn’t something I heard, and so I hope that that’s something we can continue with the momentum and keep building.
Interviews have been edited for length and clarity.
RMA26 was held at the Adelaide Convention Centre from 22 to 24 October.
