Prior to commencing rural practice I spent three years training in emergency medicine, anaesthetics, surgery, caesarean sections etc. There were no medical mishaps yet these procedures were stopped in the two country towns I worked in. It is therefore important not to create unnecessary problems and where problems exist to counter them. Health departments in particular need to be clear about their aims and should value rural doctors as a scarce resource and include them in deliberations about change. The ultimate criteria for decisions on rural workforce and hospital facilities should be the maintenance of essential services sufficient to provide safe medical care to rural and remote Australia and to utilise the full skills of doctors already resident in those areas.
Flexibility is also essential from medical organisations and statutory bodies.
An example was a GP with a qualification in psychiatry who wished to practise it on a 40 per cent time basis. National Specialist Qualification Advisory Committee regulations did not allow him to be classified as a consultant psychiatrist, making his practice financially unviable. So I could only charge the same fee as a dermatologist for prolonged consultations and this simply wasn't financially viable. I was sad to leave after ten years, but the more of my speciality I did, the less I earned, and we were simply getting deeper into debt. The increasing accent on rural issues in undergraduate medical education, the rising proportion of women doctors and the decreasing migration of doctors trained outside Australia, make it difficult to estimate the needs for rural workforce in the next decade.