The Royal Australian College for General Practitioners (RACGP) recognises that in many rural and remote areas across Australia, general practitioners (GPs) with advanced rural skills training provide the only specialist medical services to which communities have access. Rural GPs respond to changes in patient needs and work to minimise barriers to healthcare access.
The term ‘rural generalist’ has emerged, in large part, from the development of various state-based workforce models that are seeking to address patients’ needs in rural communities.
One of the priority tasks for the Rural Health Commissioner, when appointed, will be to develop a National Rural Generalism Pathway (NRGP). To assist with this task the RACGP has released its Position Statement – Rural Generalism 2020. This position statement sets out a clear definition of the term ‘rural generalist’ and the parameters that must be considered in determining the pathway.
The RACGP contends that GPs are generalists by definition. The term ‘rural generalist’ describes a rural GP working to the full scope of their practice with skill sets that are informed by the needs of the community they serve. These skill sets may encompass both advanced procedural and non-procedural skills with an emphasis on emergency medicine.
The unique characteristics of rural and remote Australia offer diversity in the range of complex health presentations and provide opportunities for GPs to expand their skills and take on a wide variety of clinical opportunities.
The development of advanced skills should be aligned to the specific needs of the GP’s community and equal focus should be given to both non-procedural and procedural skills. There is undeniable value in providing medical procedure services in rural and remote communities. Without them emergency and maternity and various other essential services would not be available locally. However, they are not the only additional skills required to address patient need.
Research conducted by RACGP Rural in 2013 demonstrated that mental health is the most commonly practised advanced skill followed closely by emergency medicine and chronic disease management. The most common skill that GPs would seek to acquire to meet a community need is emergency medicine, followed by palliative care, paediatrics and mental health.
The RACGP believes that a NRGP could enhance and complement the current rural workforce if it allows for advanced skill acquisition to be aligned to community need and acknowledges that rural generalism is not a one-size-fits-all solution.
It is vital that future policy development supports efforts to increase the number of doctors working in rural and remote Australia. We need to attract and retain a skilled rural workforce that is responsive to need. A NRGP must acknowledge the contribution that quality general practice makes to the healthcare system and its essential and enduring role in supporting rural communities.
The RACGP looks forward to working collaboratively with the Rural Health Commissioner and other key stakeholders to enhance broad rural health policies and training pathways.