Profile of a Solo Rural Practice

Ahmed Sharif1,, Zaman Bhuiyan2

1.What Gippsland Medical Clinic, Warragul, Victoria.

2.Ouse General Practice, Ouse, Tasmania.

Introduction:

The attractions of rural Practice are multiple, and there a challenges as well as rewards..1 Different models of these challenging and rewarding practices vary according to the practice population, remoteness, infrastructure and availability of practitioners as well as many other factors. Many rural practices have to constantly adjust their business and operational plan to ensure viability.

We present the profile of General Practice, which like many of its class has challenges and rewards. Some of these are unique while many others are generic. The aim of this presentation is to share the experience of working in such a rural practice with the fellow Australian  GPs.

Settings:

Type -  Solo rural practice

Location: Ouse ,Central Highland, Tasmania, 90 km Northwest of Hobart.

Co-located in the premises of Ouse District Hospital which is 14 bed hospital including acute care and nursing home beds.

Practice population: 1500

Serving Ouse, Hamilton and surrounding township and village of Central Highland.

Management,recruitment and maintenance:

Done by River Medical Services – based in WA

The hospital provide infrastructure, consumables and nursing support.

Over the last few years the practice has been run by various overseas trained doctors including the  authors.

Activities and Mode of Operation:

The practice provide all spectra of family Medicine.

The GP has VMO rights at the ospital.

Open 3-5 days a week including one evening session.  The GP works one day per week in a group practice in the neighbouring towns of New Norfolk (50 km away).

 He is on call for night a week and on alternative weekends

The New Norfolk practice renders rest of the  on call coverage.

Holidays and locum coverage organised  by Rural work force Agency (which provide locum subsidy as well) and by River Medical Services.

Rewards for the GP:

The ability to practice all spectra  of family medicines.

Call sharing with other town.

Ongoing learning and follow up  opportunity through hospital work.

Opportunity to work in New Norfolk (group).Practice help  maximising income and minimising professional isolation.

Additional income through hospital/nursing  homework.

Generous stand by own call allowance by the state Dept., of Health.

Free furnish 3-bed room house provided by the local shire council.

The GP does not have  to take care of  business management.

Steady and appreciative clientele.

Very supportive and caring local community.

Challanges:

Socialising – worse for OTD from cross-cultural background.

Difficulty in attending  CME programmes.

Pressure of on call.

Inadequate schooling facility for children.

Lack of work opportunity for the spouse.

Lack of shopping  facility- the GP needs to travel Hobart for most things. And wait  till alternate weekend for that.

Conclusion.

The challanges of working in Ouse are similar to those in many rural other practice.2,3 However, it is professionally and financially very rewarding for a GP who does not have school going children and who is prepared to be on call most of  the time.  Both of us have past the FRACGP examination on the first attempt and a major part of this success is  attributed  to our professional exposure at Ouse.

References:

1.Sen Gupta TK. Why I like rural practice. Aus Fam Physician 1993;22(10):1862-3.

2,Wearne SM. Eflections on a year in the outback MJA 2002;177(2): 117-8

3Humphreys JS Jones MP, JA, Maara PR. Work force retention in rural and remote Australia:determining the factors that influence  length of practice. MJA 2002;176:472-6.