Dr Pieter Mourik, Albury Wodonga
This month, I want to report on the three best things about rural medical practice; they are lifestyle, lifestyle and lifestyle!
Let’s face it, medical practice is much the same wherever you go, except that the breadth of practice grows the more isolated you are. If you only want to consult (and I would be bored to an early death doing this), you can work in the city, refer all your procedures and do no night calls.
If you want a lifetime of interesting and rewarding work, go bush, learn extra procedure skills and join a group to share the after-hours calls. I have just read the Rural Doctors Association of Australia’s “Rural Pulse” magazine. Several rural lifestyles are described and all report on the satisfaction of living and working in a rural environment. The comment from one writer was, “I have never been bored at work”; could a city GP honestly say this after 30 years?
Out-of-hours calls are onerous, but rural people are different; they rarely call the doctor unless it is something serious. These calls can really test your skills, but this is where your
advanced training kicks in and knowing that you can have back-up a phone call away, reduces the stress of managing potential life and death situations. It is vital therefore, to advance your skills to be able to manage these emergencies. The other thing you need to practice in the bush is courage and this comes naturally with experience and adequate training.
A doctor friend of mine recently “retired” from a consulting general practice but soon became bored, so she upskilled and is now doing locums for isolated and often solo general practitioners and is loving it! Even in retirement, she will continue to make a valuable contribution to medicine for several more years. National registration makes it easy to go anywhere in Australia to help out and it’s not a bad way of seeing parts of Australia you may never have dreamed of visiting.
I am delighted that the state governments are coming to realize that procedural general practitioners are essential in the bush and the programs are providing the training and the skills necessary to practice in the country. Having appropriate training reduces your stress when faced with an uncommon or serious medical or surgical emergency. It may sound bizarre, but you almost look forward to your next emergency to practise your skills!
When I started in general practice in 1979, the “old style” general practitioners were still practising high quality medicine and surgery. These doctors did all emergencies (there was no-one else to hand them over), did all the confinements including Caesars, did all their own patients’ appendectomies, gave all the general anaesthetics, looked after all the sick neonates and children (no specialist paediatricians then), managed road trauma until the patient could be transferred to a city and used a wide range of skills for a wide range of medical possibilities. This was truly “holistic” practice.
Perhaps this broad scope of practice is no longer possible or recommended, but it is important to have advanced skills in one or perhaps two areas. Then, if you join a group of doctors with a different skill mix, you can provide a rural community with high quality service and prevent having to send “routine” cases to the city. Joining a group of well-trained procedural doctors to share the workload gives you the opportunity to enjoy the lifestyle, lifestyle and lifestyle; the three best things about rural medical practice.
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