Rural generalists such as Dr. Alan Richardson from Tasmania are exporting their skills. They are going to areas where their expertise is needed most. Every few weeks, Dr. Richardson travels to rural Queensland to deliver babies, showcasing a troubling trend: skilled medical professionals are unable to find suitable positions within Tasmania. This unfortunate reality points to the drastic workforce shortages that are straining regional hospitals around the state.
Dr. Richardson is a fully qualified rural generalist, trained in emergency care and essential advanced skills. Sadly, most of these qualifications are still not used to their full potential here in Tasmania. Ben Dodds is a champion for rural healthcare. He argues that rural generalists are ideally placed to make a big dent in workforce shortages at district hospitals such as Deloraine and St Helens. Chances for these practitioners are few because of cut down services in these buildings.
The quandary goes beyond nurses to other members of the healthcare workforce too. Dr. Claire Griffiths, a previous trainee rural generalist from Burnie who spent four years attempting to complete her training. Now, she’s getting ready to depart Tasmania, eager to take what she’s learned and do the work in a different context. She has added to this wealth of experience working at the North West Regional Hospital and the Mersey Community Hospital. What’s in store for her remains an open question.
The Role of Rural Generalists
Rural generalists are anything but run-of-the-mill general practitioners. They have specialized training that prepares them to respond in emergencies and to address diverse healthcare needs. Ben Dodds speaks passionately about the role of these professionals to bridge gaps in our healthcare system.
“We know that there are dire workforce shortages of … specialists in rural and remote Tasmania,” – Ben Dodds
Qualified as they might be, rural generalists are often left without positions that suit their skills. Dodds shines a light on an important point. Rural generalist obstetricians have no role at these important facilities today. This absence of federal government support makes healthcare access in regional areas even more challenging.
The increased dependence on locum doctors has further compounded the issue. The Mersey Community Hospital and the North West Regional Hospital have historically preferred specialists to fill vacancies, even if it means incurring significant costs through locum services. Even in just the last fiscal year, these facilities have spent more than $100 million on locums FTE.
Efforts to Integrate Rural Generalists
Fortunately, the Tasmanian Health Department has acknowledged that the current state of affairs is unsustainable. So they’re working — very intentionally and very specifically — to mainstream rural generalists in the healthcare ecosystem. A department spokesperson dropped some thrilling new positions on us. These roles will be piloted at the North West Regional Hospital and the Mersey Community Hospital to address immediate priorities.
“New roles will be trialled across the North West Regional Hospital and the Mersey Community Hospital, aligned with current areas of need in the region’s medical workforce,” – Health Department Spokesperson
A policy has been introduced at the state level to require that rural generalists be offered employment before locum doctors are engaged for particular positions. There are similar, if less advanced, conversations happening right now about creating pathways for rural generalists with advanced training in fields like emergency medicine or anesthesiology.
Despite these efforts, challenges remain. Dr. Hawkins is Tasmania’s regional director of training for the Australian College of Rural and Remote Medicine (ACRRM). He points out that many of those graduates tend to leave Tasmania in search of jobs that fit their level of expertise.
“Every other state in Australia uses rural generalists in one way or another … but Tasmania is not set up for that.” – Claire Griffiths
Dr. Griffiths cheers this development. It disturbs her deeply that her professional training restricts her from providing value to the community she calls home.
The Future of Healthcare in Tasmania
The changing healthcare landscape in Tasmania has created some important and interesting conversations around the greatest and highest use of talent. At present there are 70-80 registrars in training across the medical specialties of emergency, obstetrics, anaesthetics, mental health, paediatrics and internal medicine. This rich tapestry of training has generated the promise of an entirely new model of healthcare delivery.
“We’ve really hit major barriers with that, in terms of the senior executive at the Tasmanian Health Service not understanding how this could be an ideal solution for Tasmania to increase Tasmanians’ access to health care and reduced costs on the health system,” – Ben Dodds
This workforce model—championed by staffer Ben Dodds—would provide hospitals the flexibility to hire rural generalists as well as subspecialists. This innovative approach improves service delivery, reducing the need to recruit locums. This targeted strategy would better ensure that the most skilled practitioners stay in Tasmania, while providing better healthcare, in all forms, to the island’s residents.
Premier Jeremy Rockliff has committed more than a year ago to implement a rural generalist model. Its implementation has lagged woefully behind. Action is needed now. Patients and healthcare professionals alike are raising their voices in protest against this unjust state of affairs.
