An accelerating decline in procedural rural practice (particularly obstetric, anaesthetic and operative surgical services offered by generalist doctors) is now widely acknowledged. The fact that many doctors no longer offer procedural services has a heavy impact on individuals and communities in rural and remote areas where access to health services is already limited and health outcomes are generally not as good as in urban centres.

Maintaining procedural practice is a priority for ACRRM and it has been integrally involved in research to identify the issues, consultations to generate solutions and forming partnerships with the profession and government to try to redress this problem.

Key ACRRM research reports and documents on Procedural Rural Medicine appear below:

ACRRM research:

Barriers to maintenance of procedural skills in rural and remote medicine

This ACRRM research activity was designed to provide current indications of the barriers to procedural practice which rural and remote doctors considered were the most difficult to overcome or had the most immediate effect. Outcomes include a typology of issues affecting the attainment and maintenance of procedural skills, ranking of priority issues by practitioners and establishment of a process to forward professional, education and training issues as well as industrial matters.

ACRRM research:

Factors influencing the relocation of rural proceduralists

In addition to understanding the barriers to maintaining procedural skills in rural medicine it is useful to examine the principal issues influencing those doctors who leave procedural practice and relocate to provincial and urban settings. This ACRRM research activity investigates the underlying reasons for proceduralists’ decisions to change location and form of practice, the role in these decisions of barriers to the maintenance of procedural practice, and the role in these decisions of other issues (family, lifestyle, personal well-being etc).

ACRRM Solutions Paper: Issues in the attainment and maintenance of procedural skills in rural and remote medicine

Following the research into barriers to the maintenance of procedural skills, ACRRM instituted a series of national consultations and discussions regarding potential solutions to problems and identification of agencies most likely to address concerns. The Solutions Paper defines points in the vertical integration of education and training at which action can be taken to promote procedural medicine to young doctors, develop a more focussed education and training approach and work with all layers of government to encourage the preservation of facilities and services within which proceduralists can work.

ACRRM and RDAA: Procedural Rural Medicine – strategies towards solutions

This paper was prepared for the AHMAC Rural Health Policy Subcommittee in October and subsequently also presented to the Rural and Remote Standing Committee of GPPAC. The paper identifies the need for a national strategic framework within which practical strategies to halt and reverse the decline in procedural rural medicine could be implemented at all levels. Its conclusions are based on the recognition of procedural rural medicine as an important factor in health outcomes for rural consumers and the wellbeing of rural communities.

National Symposium on Procedural Rural Medicine: Recommendations

ACRRM and RDAA held a multi-disciplinary symposium in Hobart in March 2003 to determine practical ways of implementing appropriate action to redress the decline in procedural medicine. Key recommendations focus on: Attracting the next generation of procedural doctors (recruitment & training); Supporting the procedural workforce (recognition, infrastructure and skills maintenance); Monitoring and evaluating current initiatives; Identifying good working models for wider application; and Enhanced collaboration between all levels of government.

Report to the General Practice Partnership Advisory Committee

Copy of the position paper and recommendations provided to the Rural and Remote Standing Committee of GPPAC. All recommendations were endorsed by the Standing Committee and full Council of GPPAC in June 2003. These strategies were referred directly to the Minister for Health and Ageing.