The Royal Australian College of General Practitioners (RACGP) General Practice: Health of the Nation report shows promise for the future of rural general practice.
An annual health check-up on general practice in Australia, the Health of the Nation report draws on publicly available data, as well as the Health of the Nation survey of RACGP fellows from across Australia. This year's survey was undertaken by EY Sweeney during April-May 2021, with 1386 respondents.
This year's report highlights strong and growing interest among GPs to work in rural health, offering hope for the future health of rural general practice and communities, including:
Almost three in five (59%) GPs in training report an interest in rural practice, compared to two in five (40%) of other specialists in training. While two out of five (44%) GPs in training report that they intend to work in urban areas post-Fellowship, a larger proportion (48%) plan to work in rural or a mix of urban and rural locations.
RACGP Rural Chair Dr Michael Clements said the trend was promising for the future of rural general practice, despite considerable challenges.
"As a rural GP myself, I know what draws GPs to go rural – it's a rich and rewarding career, with endless possibilities. You become a valued part of your community, and really get to know your patients," he said.
"The scope of work in rural practice is also truly unique. No one day is the same, you might have to attend to an emergency, a birth, support someone with mental health concerns or a chronic condition.
"The fact that this year's Health of the Nation report shows growing interest in rural practice among GPs in training is very promising. As the peak representative organisation for general practice, addressing the workforce gaps in rural and remote Australia and improving access to high-quality general practice is our priority.
"Accessible and high-quality general practice is vital to the health of Australia; GPs are the first point of contact for most Australians seeking medical attention, with 85% of the population seeing a GP at least once each year."
Increasing the number of highly trained GPs in rural and remote communities is a key priority for the RACGP. With the Federal Government returning the delivery of general practice training back to the medical colleges, the RACGP is committed to increasing the number of highly trained GPs in rural and remote communities.
The RACGP's proposed model for general practice training aims to attract more graduates to become GPs, and do their training in the communities that need them most, particularly rural and remote areas.
Dr Clements said the RACGP was also finalising its planned offering of FRACGP – Rural Generalist, which will see the College's traditional Fellowship of Advanced Rural General Practice adapted and aligned to the National Rural Generalist Pathway rollout.
"We are committed to offering training that meets the changing workforce needs in Australia's rural and remote communities, and recognises the additional skills needed to provide care to these communities," he said.
"This is why we are revising our rural curriculum to offer fellowship programs to suit rural GPs, including the Rural Generalist Fellowship – with a view to boosting the support to, and number of highly skilled GPs in rural communities, working across both hospital and community practices.
"Everyone deserves to be able to access a good GP no matter their postcode. Of course, we know this is not the reality – in many parts of rural and remote Australia the shortage of GPs is at crisis point.
"We know that the lack of access to high-quality healthcare is impacting people's health and wellbeing. People in rural and remote communities are less healthy overall and experience higher rates of chronic conditions and shorter life expectancies."
The Health of the Nation report found that more GPs in rural and regional areas are managing patients with multiple health conditions – often referred to as multi-morbidity. 79% of GPs outside of major cities report that the majority of their patients have multi-morbidity compared to 69% in metropolitan areas, which Dr Clements said creates complexity for care in the bush.
"GPs are the only medical practitioners that specialise in managing multi-morbidity for patients from paediatrics to aged care. What is concerning is that multi-morbidity is rising in Australia, which is increasing the complexity of care required, particularly for GPs in the bush," he said.
"While this year's Health of the Nation report shows there is strong interest in rural health among Australian GPs, GPs are the only category of doctor that has seen a faster growth in numbers in major metropolitan areas than in regional rural and remote areas. The number of GPs outside major cities has grown by 3.4% per year since 2013, compared to growth of 4.8% among all doctors.
"Clearly, we need to do more to incentivise and adequately renumerate GPs to train and live in rural and remote Australia. While we are making gains, we have a long way to go, and it should be a priority for government – because we are talking about people's lives, access to high-quality healthcare is essential to living a healthy, happy life."
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