Regional and Rural Health Services
Issues of Healthcare Equality
Challenges of Working in Rural and Regional Regions
Benefits of Working in Rural and Regional Regions
Australian government for many years has put lots of money into trying to address disparity in the medical workforce.
Funded rural clinical schools - set up in rural places, have professional academic staff and students from various units (especially metro based) go out and have a rural placement experience --> get a taste of what it is like to work in rural
Established uni department of rural health - for a range of types of health professionals, meant to give people access to professional development as well as research opportunities
Lots of grants are also given out to encourage medical students to work in rural areas and do rural placement
Established specific rural medical schools
Funds a number of rural workforce agencies - encourage people to work in rural areas, often have access to rural workforce incentives and other living incentives
More use of Telehealth - used for psychology, accident consultations, could be between specialist services and people in small rural hospitals or potentially limitless as more access becomes available.
Need to love and embrace it - understand that there is a different style of healthcare involved which is much more autonomous and extended
Have to be comforted with working outside a very defined role
Continuity between lifestyle and work
People working in rural practice have to understand that they will have to engage to an extent in rural community life (hard to be an anomous person)
Its not just about the health professional themselves but their families --> family also has to feel like they fit into rural community
Can be hard for both people to get a good job that they like in rural area
Career progression can be seen as a problem - not the access to the developed career roles, not obvious where to go next
Less access to promotion jobs
People have to be creative in extending their jobs, taking every opportunity for professional development (can be hard to access)
Staying within the scope of practice --> may be the only professional or one of a small team, lots of different health problems will present and they will have to make sure they are performing in a safe way within their scope of practice even though there may be a temptation to help a patient by doing a little bit more
More opportunities to be autonomous
Drive your own job to an extent (what you do, how you do it, control over hours) (style of working)
Important during career progression
Develop own style of practice very much
Rural practice is extended (variety)
Opportunity to extend role
Be creative and embrace new things like technology and Telehealth and look st developing competencies
Can be good that patients know you --> can be supportive, may be more compliant, may help and volunteer for work in clinic (develop relationships with patients)
Great lifestyle
Cheaper cost of living
Good quality of life can be enjoyed
Experience of rural working can be good if want to work abroad because have developed way of being autonomous and a wide range of work, etc.
Range of work experience and responsibility able to be taken on at an earlier stage
Healthcare rural VS urban
As get more rural, statistics show people have lower income, lower levels of educational achievement, fewer access to a range of opportunities
Fewer economic opportunities and fewer choice of places to work, lack of highly paid professional jobs and consequently less middle class or well-off people with a higher socioeconomic status
Central Australia -> higher populations of indigenous people, suffered for many decades of chronic trauma and disadvantage form colonisation (have more indigenous people living in urban areas than rural areas in total
Issues of rural living
Culture that tends to be reinforced from living in small communities with few people, practices become entrenched and becomes difficult to break out of (healthy living practices and exercise may be difficult to do if not accepted as the norm in the community)
Glorification of city living (to live in the city is to have made it and have all the benefits and opportunities of life)
Professionals in rural areas often send children to boarding school -> means there is often a drain away from rural areas of these professional and highly educated people
Have less access to services and have less choice -> less access to specialist services as there are fewer hospitals and specialist practices in rural areas, means they must travel
Services available in rural areas tend to be more generalist and practitioners will have to do a wider range of work
Key features missing in rural health that lead to poorer disparities
Accident and emergency services
Poorer access to services for cancer (both screening and treatment)
Cardiovascular services
Basic public health level
Cultural uses
Lots of occupational injuries in rural areas from agriculture as well as travel injuries from car accidents etc.
Often far away from ER department with specialist professionals or equipment to deal with particular kinds of accidents
Get poorer outcomes from accidents in rural areas
Rural people will have to travel some distances for screening and treatment
Acts as a detriment to accessing these services for people who are ill or need to be screened for cancer
Less accessible for rural people because high quality services are more largely available in larger facilities
Less access to good food and the variety of food
Generally rural have a lower income and have less money to spend on things like food and travelling to access specialists services
Tend to be issues around health practices in rural areas and rural people may have poorer health behaviours (particularly men) -> more resistant, engage in risky behaviours (rural sports)
Confidentiality - they will know their health professionals and may not want to share a problem that they have (mental health)
Aspect of continuity - will have health professionals who know them and know their family and history of health issues (more personal service)