Working in a rural or remote
location can be an attractive option for some doctors. A pleasant lifestyle in
an interesting location can be combined with a close working relationship with
a small community and a high degree of autonomy seeing a varied case mix of
patients.
However, the wellbeing of rural doctors can be threatened by
a number of factors that can be difficult to control. Taxing on-call
arrangements, high community expectations, limited opportunities to take
recreational leave, and little opportunity for continuing professional
development are some of the issues rural doctors have to deal with.
Importantly, accessing peer support represents a particular challenge that can
leave doctors feeling isolated and burdened.
The beyondblue 2013
National Mental Health Survey of Doctors and Medical Students [1]
found rural doctors are more likely than any other doctors to suffer from
mental health disorders, with 3.4% recording very high levels of psychological
distress. Nearly a third (29%) of doctors working in rural, remote, or
Aboriginal health said they were stressed by work hours.
“In the
absence of good on-call arrangements and professional support, the
unrelenting nature of after-hours care imposes an excessive workload, with
negative effects both on GPs' (and their families') health and wellbeing, and
on their opportunities to enjoy their rural location,” said the authors of a
study published in the Medical Journal of Australia into the retention of
rural and remote GPs[1].
Isolation is a key risk factor for poor health
amongst all health professionals, not just those working in rural placements
[3].
The key to maintaining wellbeing is to receive adequate
workplace support. Structural health system changes including the recruitment
of more rural doctors to provide a more reasonable on-call ratio, the
provision of appropriate locum services and the development of better
regional medical practice models have all been suggested as ways of easing the
burden on rural doctors.
Nevertheless, for now rural doctors are still generally
responsible for seeking their own support and a range of options available.
There are several ways that rural and remote doctors are able to access
continuing professional development (CPD), which has been shown to be
important for improving doctors’ wellbeing as well as patient outcomes
[4].
The Rural Health Continuing Education (RHCE) Program
offers grants to enable rural specialists to undertake specific CPD
activities, as well as project grants for specialist medical colleges to
develop CPD initiatives tailored to medical specialists in rural and remote
areas.