The distinctive red helicopters and yellow planes are a frequent sight, attending accidents and medical emergencies. As the importance of rapid, expert treatment of trauma cases is increasingly realised these services will be used more. The increasing popularity of outdoor sports is also putting pressure on volunteer and RAF mountain rescue services, both of which have important medical input. General practitioners in remote or isolated areas, where a trip to casualty or a specialist referral may involve a helicopter ride or several hours on a ferry, often practise extended skills. An example would be wide excision biopsies of suspected malignant melanoma, a service more commonly performed in dermatology clinics.
Judgments often have to rely on a clinical assessment alone.
The doctors must be able to turn their hand to many tasks, and confidently manage situations out side their immediate skills. In some ways it is not dissimilar to working in a less developed country, and it is no surprise that many of the doctors have spent time working for Voluntary Services Overseas or similar organisations. Rural areas and issues are rising to greater political prominence and the need to provide additional funding and find new solutions is growing. In these days of a newly reinvigorated Scottish democracy, the highlands and islands are an exciting and challenging area to work in.