People living in rural Australia are probably not surprised to hear that a sixty-six year old woman bled to death in a regional hospital at Gulgong, near Mudgee. She was suffering a gastrointestinal bleed and there was no doctor available to treat her.
That is a warning to tourists travelling the inland road system. Just because road signs and maps indicate that there is a hospital in the town ahead, there is no guarantee that a doctor will be present. In todays world it may offer video conferencing with a doctor located far away in the state capital.
Usually, there is insufficient work demand to keep a doctor permanently stationed at these small regional hospitals and they are serviced by the local general practitioner whom runs a private practice in the town. He or she has had special training to work in hospitals and attends the hospital on a call out basis.
There is a dire shortage of doctors willing to work in country towns and many that do find the workload excessive. Not only do they care for the health of the townsfolk, this usually includes the vast surrounding farming district, and their responsibility for service in the regional hospital seriously depletes their lifestyle. Often they suffer " burnout " and leave after a few short years.
It does put a burden on the family life most people expect to enjoy. A weekend away leaves the town without medical cover, and alcohol needs to be avoided in case they are suddenly called to perform surgery at the hospital.
Many country towns are now lacking a resident general practitioner despite lucrative enticements to attract someone to set up practice. Sometimes this includes a house and surgery either free or at very subsidized cost, but even that fails to attract interest.
Country hospitals are becoming more reliant on the air ambulance services for medical retrieval and getting the patient to a fully equipped major hospital in the state capital. Unfortunately, distance dictates the flying time involved in the round trip and sometimes immediate medical attention is critical.
Major city hospitals are served by a helicopter fleet of air ambulances and the very remote parts of Australia are served by the Flying Doctor service, but the vast majority of country hospitals rely on the services of locally based general practitioners for their medical needs.
This shortage is not helped by the split responsibility for oversight of medical services. The hospital system is entirely under state control while the Federal government funds medical practice. It is the Federal government that controls the number of new doctors emerging from medical schools and it has been suggested that a compulsory term of service in a country district should be part of the registration regimen. That is resisted by most medical groups.
A New South Wales Health spokesperson said the state was working with the Commonwealth to expand the generalist training programme and $2.8 billion was invested to increase hospital staff across the state. Of this, forty-five percent was ear marked for regional and rural areas.
Unfortunately, whether you find a doctor waiting to treat you in a country hospital still seems to be in the lap of the Gods !
No comments:
Post a Comment