Q&A - Life and times of a rural and remote practitioner

Obviously, this can be very challenging, but it is important to remain level headed and professional. You must assist the family deal with the reality of death and its consequences. It is critically important for health practitioners to communicate bad news, explain the circumstances and provide support.

Again, an issue for the rural and remote practitioner. It is important to build up a network of colleagues and friends who can readily communicate with, if not face to face, then electronically, to listen and provide advice and support. Importantly, you need to maintain an appropriate work life balance. An unwell doctor may not provide appropriate care.

Yes, they do. There can be a time lag between a specialist prescribing and treatment. There is not the breadth of medicines available remotely, they can have a limited life span and or there may be storage issues in rural and remotes areas.

Very much supported, they can be a fantastic resource. From time to time there can be a misunderstanding of the resources and skills available at our end, but generally they are very supportive.

Mistakes are common in medicine – whether they be delays in diagnosis, prescribing errors or the many other types of errors we encounter on a day to day basis.

I think the first and most important step in dealing with error is to contact either your supervisor or your medical indemnity provider, and discuss the issue with them. Following this discussion, embarking on open disclosure with the patient is an important second step to acknowledge and address the error.

Finally, encouraging your patient to discuss the error with you or with an independent patient advocate is an important step in finalizing the management of the error, and ensuring that the patient is satisfied with the outcome. More information on this process will be available from your medical indemnity provider.

In our centre we regularly are visited by members of the Townsville Hospital Emergency Department as part of their outreach, and we are closely integrated with our district hospital. These arrangements are very important to foster the understanding of medicine in a remote area and to facilitate learning of doctors like me who work remotely and away from dedicated support. That being said, regular meet and greets are often expensive to get to, and sometimes don’t result in the information sharing that we’d like, especially when they occur in the tertiary centre instead of out in the regional area.

I think that all hospitals should actively seek to engage their employees, and by extension rural GP’s and rural generalists, in upskilling and information sharing so that all members of the organization have an understanding of rural medicine, and the challenges involved in delivering care in an information poor environment.

Generally, this has been quite beneficial, as the GP sitting with your patient who otherwise would have had to travel or take the time to meet a specialist face to face. There are now Medicare item numbers available for this type of practice. Overall a very beneficial and practical improvement to patients and practitioners in rural practice.

I have encountered this, and as a public hospital employee this is handled through my hospital legal team as a Freedom of Information Request. I would encourage this member to discuss with MIPS this particular scenario.