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15 Feb 2019

BY DR SANDRA HIROWATARI, CHAIR, AMA COUNCIL OF RURAL DOCTORS

At an AMA Council of General Practice meeting last year, we discussed the skill of knowing how to live rurally. One of the challenges many young doctors face when they first move to a new rural or remote town is socialising. How do you relax at ‘the local’ when everyone is a patient? How do you date? How do you negotiate these boundaries?

Rural doctors work longer hours on average than their urban counterparts. This leaves less time for sleep, for leisure, for friends and family.

But there are also challenges that we share with all doctors. One challenge that the AMA spent a lot of time fighting in 2018 was getting Australia’s mandatory reporting laws right. This is an issue that affects all doctors (except in Western Australia where the laws make more sense), but an issue which affects rural docs more acutely.

When you are one of a few local doctors and one of your colleagues comes to you, what do you do? Do you break the law risking your own career? Or do you report your colleague, removing one more doctor from a town desperately short of doctors already? This would ensure that no other doctor in town would seek help.

Last year there was a lot of discussion about Professor Steve Robson’s heartfelt personal account of his time as an intern in rural Queensland. After an attempt to take his own life was interrupted by a colleague checking up on him, he set about dealing with his mental health. He saw his GP. Their advice: don’t tell anyone.

Progress has been made, but the stigma still exists and there are other challenges, particularly for rural doctors. If Steve had wanted to talk to someone despite the advice he received, the only psychiatrist he knew in town was about to become his supervisor. As it was later revealed, his colleagues had to hide the help they provided even from him.

Know who you can turn to when you need help. In one of my articles last year I wrote:

find someone to help you, someone you can trust. Let this someone not be yourself.”

As rural doctors we are used to the challenges of living rurally and we love it. We want more doctors to come and join us. In 2018, the AMA had major successes with the progress made on the National Rural Generalist Pathway and the Stronger Rural Health Strategy announced in the budget. These initiatives were heavily influenced by AMA advocacy over many years.

But just when it seems progress is being made, the positive developments are undermined by laws like mandatory reporting that will punish doctors for seeking help. If mandatory reporting laws are not fixed in Australia, this issue continues to be a serious one for all doctors. The AMA will continue to advocate for laws which protect all doctors in 2019.

It’s not always easy out bush, but we build networks to support each other. We need to be able to trust these networks. This is just one of our skills, but it is an important one.

 


Published: 15 Feb 2019