Alan B. Chater

Determinants of rural practice: positive interaction between rural background and rural undergraduate training

Objective: To determine the role of rural background and years of rural clinical school training on subsequent rural clinical practice.

Looking after health care in the bush

LOOKING AFTER health care in rural Australia involves providing adequate services to meet the urgent and non-urgent needs of rural patients in a timely, cost-effective and safe manner. The very provision of these services requires an appropriate workforce and facilities in rural areas. This provides challenges for clinicians, administrators and medical educators. While preventive medicine has made some significant gains globally in reducing the need for acute care and hospitalisation in some areas of medicine such as infectious disease and asthma, these demands have been replaced by an increase in trauma, chronic disease and mental illness1 which, with an ageing population, eventually means presentations at an older age which can require hospitalisation. Rural patients have always had to deal with a relative undersupply of health practitioners. Rural people have coped valiantly with this. The legendary stoicism of rural people has been shown by Schrapnel2 and Davies to be a prominent feature of the rural personality. This both allowed them to cope with lack of services and to suffer in silence while their health status fell below the Australian average.3 Rural Australians use fewer Medicare services and see the doctor less per annum than the Australian average.